Article

Impact of genetic abnormalities on survival after allogeneic hematopoietic stem cell transplantation in multiple myeloma.

Department of Oncology and Hematology, Medical Clinic II, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Leukemia: official journal of the Leukemia Society of America, Leukemia Research Fund, U.K (impact factor: 8.3). 06/2008; 22(6):1250-5. DOI:10.1038/leu.2008.88
Source: PubMed

ABSTRACT We analyzed the prognostic impact of the most frequent genetic abnormalities detected by fluorescence in situ hybridization in 101 patients with multiple myeloma, who underwent allogeneic hematopoietic stem cell transplantation (HSCT) after melphalan/fludarabine-based reduced conditioning. The incidences of abnormalities in the present analysis were as follows: del(13q14) (61%), t(11;14)(q13;q32) (14%), t(4;14)(p16.3;q32) (19%), MYC-gain gains (8q24) (21%), del(17p13) (16%) and t(14;16)(q32;q23) (5%). None of the patients had t(6;14)(p25;q32). The overall complete remission (CR) rate was 50% with no differences between the genetic abnormalities except for patients with del(17p13) who achieved less CR (7 vs 56%; P=0.001). Univariate analysis revealed a higher relapse rate in patients aged >50 years (P=0.002), patients with del(13q14) (P=0.006) and patients with del(17p13) (P=0.003). In multivariate analyses, only del(13q14) (HR: 2.34, P=0.03) and del(17p13) (HR: 2.24; P=0.04) significantly influenced the incidence of relapse, whereas for event-free survival, only age (HR 2.8; P=0.01) and del(17p13) (HR: 2.05; P=0.03) retained their negative prognostic value. These data show that del(17p13) is a negative prognostic factor for achieving CR as well as for event-free survival after HSCT. Translocation t(4;14) might be overcome by allogeneic HSCT, which will have implication for risk-adapted strategies.

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Keywords

abnormalities
 
cell transplantation
 
complete remission
 
conditioning
 
event-free survival
 
frequent genetic abnormalities
 
genetic abnormalities
 
higher relapse rate
 
HR
 
multiple myeloma
 
MYC-gain gains
 
negative prognostic factor
 
negative prognostic value
 
patients
 
present analysis
 
prognostic impact
 
relapse
 
risk-adapted strategies
 
situ hybridization
 

G Schilling