Journal
LEUKEMIA
Volume 22, Issue 4, Pages 850-855Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/sj.leu.2405091
Keywords
myeloma; cytogenetic abnormalities; prognosis
Categories
Funding
- NATIONAL CANCER INSTITUTE [P01CA055819] Funding Source: NIH RePORTER
- NCI NIH HHS [P01 CA055819, CA55819] Funding Source: Medline
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Cytogenetic studies were performed as part of all diagnostic and surveillance bone marrow examinations in 956 newly diagnosed patients with multiple myeloma ( MM) receiving total therapy ( TT) protocols and in 1085 previously treated patients enrolled in non-TT protocols. In both groups, cytogenetic abnormalities ( CA) were present in one-third at baseline and persisted in 14% prior to first and 10% prior to second transplant ( TT, 5%; non-TT, 15%); post-transplant detection rates increased progressively with time, from 7% within 6 months to 21% within 24 months to 28% at relapse. According to multivariate analyses, overall survival was adversely affected by the presence of CA at baseline ( hazard ratio (HR) = 7.20, P < 0.001) and the development of CA both prior to (HR = 3.28, P < 0.001) and after first transplant (HR = 6.24, P < 0.001), whereas suppression of CA pretransplant was favorable (HR = 0.38, P < 0.001). The presence of CA at relapse further distinguished patients with a short median post-relapse survival of only 11 versus 47 months in those without CA (P < 0.0001). Post-relapse survival was independently adversely affected by the detection of CA both at baseline (HR = 1.35, P = 0.044) and relapse (HR = 2.47, P < 0.001). Collectively, these results underscore the importance of monitoring for CA and attest to the favorable prognostic consequences of CA suppression with effective therapy.
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