Hyperdiploid Multiple Myeloma with Novel Complex Structural Chromosome Abnormalities Associated with Poor Prognosis : A Rare Case Report

• Published in: International journal of hematology- oncology and stem cell research Vol. 15; no. 3; pp. 199 - 205
• Main Authors: Ankathil, Ravindran, Foong, Eva, Siti-Mariam, Ismail, Norhidayah, Ramli, Nazihah, Mohd Yunus, Sangeetha, Vijay, Hariharan, Sreedharan, Azlan, Husin
• Format: Journal Article
• Language: English
• Published: Iran Tehran University of Medical Sciences, Hematology-Oncology and Stem Cell Transplantation Research Center 01.07.2021; Tehran University of Medical Sciences
• Subjects: Case Report; Multiple myeloma; Conventional cytogenetics; Interphase fluorescence in situ hybridization (iFISH); Spectral karyotyping ; Novel complex cytogenetic abnormalities; Conventional cytogenetics; Novel complex cytogenetic abnormalities; Multiple myeloma; Spectral karyotyping; Interphase fluorescence in situ hybridization (iFISH)
• ISSN: 2008-3009; 2008-2207; 2008-2207
• DOI: 10.18502/ijhoscr.v15i3.6852

Hyperdiploid multiple myeloma (MM) is associated with better prognosis and non-hyperdiploid subtype is associated with variable to adverse prognosis based on the nature of karyotype abnormality.  Rarely exceptions to this hyperdiploid and non-hyperdiploid divisions do exist in a minority. We report an adult male MM patient who showed hyperdiploid karyotype with few novel complex abnormalities and who showed poor clinical outcome. Conventional cytogenetic analysis carried out in 22 GTG banded metaphases showed 53,Y,der(X)t(X;22)(q27;q11.2),+3,+5,+6,+9,+11,+15,der(17)ins(17;1;3)(q11.2;?;?),der(17)ins(17;1;3)(q11.2;?;?),+19,-22,+mar karyotype pattern in 15 metaphases whereas 7 metaphases showed 46,XY karyotype  pattern.  Interphase FISH revealed biallelic del(13q14) and del(17p13) but no translocations involving the 14q32 region. Through Spectral karyotyping FISH, the origin of complex abnormalities involving der(17) chromosome,  translocation t(X;22), and marker chromosome could be clearly delineated. Although the present case showed hyperdiploid karyotype, he showed an adverse prognosis probably due to the co-existence of high risk and complex abnormalities and expired 5 months after initial diagnosis despite standard treatment given.