A longitudinal analysis of chromosomal abnormalities in disease progression from MGUS/SMM to newly diagnosed and relapsed multiple myeloma.
Aged
Chromosome Aberrations
Chromosomes, Human
/ genetics
Clonal Evolution
Disease-Free Survival
Female
Follow-Up Studies
Humans
Leukemia, Plasma Cell
/ genetics
Longitudinal Studies
Male
Middle Aged
Monoclonal Gammopathy of Undetermined Significance
/ genetics
Retrospective Studies
Risk Factors
Smoldering Multiple Myeloma
/ genetics
Survival Rate
Clonal evolution
Cytogenetic abnormalities
Disease progression
FISH
Fluorescence in situ hybridization
Multiple myeloma
Journal
Annals of hematology
ISSN: 1432-0584
Titre abrégé: Ann Hematol
Pays: Germany
ID NLM: 9107334
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
08
06
2020
accepted:
16
12
2020
pubmed:
5
1
2021
medline:
27
1
2021
entrez:
4
1
2021
Statut:
ppublish
Résumé
We analyzed variations in terms of chromosomal abnormalities (CA) by fluorescence in situ hybridization (FISH) analysis on purified bone marrow plasma cells throughout the progression from monoclonal gammopathy of undetermined significance/smoldering multiple myeloma (MGUS/SMM) to newly diagnosed MM/plasma cell leukemia (NDMM/PCL) at diagnosis and from diagnostic samples to progressive disease. High risk was defined by the presence of at least del(17p), t(4;14), and/or t(14;16). 1p/1q detection (in the standard FISH panel from 2012 onward) was not available for all patients. We analyzed 139 MM/PCL diagnostic samples from 144 patients, with a median follow-up of 71 months: high-risk CA at diagnosis (MGUS/SMM or NDMM) was present in 28% of samples, whereas 37-39% showed high-risk CA at relapse. In 115 patients with NDMM who evolved to relapsed/refractory MM, we identified 3 different populations: (1) 31/115 patients (27%) with gain of new CA (del13, del17p, t(4;14), t(14;16) or 1q CA when available); (2) 10/115 (9%) patients with loss of a previously identified CA; and (3) 74 patients with no changes. The CA gain group showed a median overall survival of 66 months vs. 84 months in the third group (HR 0.56, 95% CI 0.34-0.92, p = 0.023). Clonal evolution occurs as disease progresses after different chemotherapy lines. Patients who acquired high-risk CA had the poorest prognosis. Our findings highlight the importance of performing FISH analysis both at diagnosis and at relapse.
Identifiants
pubmed: 33392702
doi: 10.1007/s00277-020-04384-w
pii: 10.1007/s00277-020-04384-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
437-443Références
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