Hypodiploidy and 22q11 rearrangements at diagnosis are associated with poor prognosis in patients with multiple myeloma

• Published in: British journal of haematology Vol. 98; no. 2; pp. 418 - 425
• Main Authors: Calasanz, María J., Cigudosa, Juan C., Odero, MaríA D., García‐Foncillas, JesúS, Marín, Ulián, Ardanaz, Mariá T., Rocha, Eduardo, Gullón, Arturo
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.08.1997; Blackwell
• Subjects: 22q11 abnormalities; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Chromosome Aberrations; Diploidy; Female; Gene Rearrangement; Humans; hypodiploidy; Immunodeficiencies. Immunoglobulinopathies; Immunoglobulinopathies; Immunopathology; Karyotyping; Male; Medical sciences; Middle Aged; multiple myeloma; Multiple Myeloma - genetics; Prognosis; prognostic factors; survival analysis; Chromosomal aberration; Human; Immunopathology; Prognosis; Malignant hemopathy; Myeloma; Diploidy; Immunoglobulinopathy; Lymphoproliferative syndrome; Gene rearrangement; Abnormal chromosome G22; Cytogenetics; Abnormal chromosome
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1046/j.1365-2141.1997.2443061.x

Our aim was to evaluate the clinical use of cytogenetic analysis as a prognostic factor in the outcome of newly diagnosed multiple myeloma (MM) patients. The present series includes 111 newly diagnosed MM patients treated with one of three standard‐dose regimens or autologous transplantation over an 8‐year time interval. As expected, the presence of an abnormal karyotype (39% of patients) correlated with poor prognosis (progression rate 63% v 47%, P = 0.042), shorter event‐free (EFS, P = 0.014) and overall (OS, P = 0.005) survival. Two distinct cytogenetic abnormalities were the most significant variables that influenced EFS and OS in the univariate analysis. The presence of hypodiploid karyotypes or rearrangements of band 22q11 were associated with higher progression rate (P = 0.001) and shorter EFS (P < 0.024) and OS (P < 0.004). The median EFS and OS for patients with hypodiploidy was 4 and 7 months respectively. Multivariate analysis showed that absence of hypodiploidy was the most favourable prognostic variable for OS (P = 0.022) followed by stage ≤IIA, serum calcium ≤2875 μmol/l, and absence of abnormalities 22q. The data suggest that the presence of hypodiploid karyotypes and rearrangements on 22q11 band show a higher progression rate and shorter survival in MM patients.