Shaughnessy JD, Zhan F, Burington BE, Huang Y, Colla S, Hanamura I, Stewart JP, Kordsmeier B, Randolph C, Williams DRA validated gene expression model of high-risk multiple myeloma is defined by deregulated expression of genes mapping to chromosome 1. Blood 109(6): 2276

Donna D. and Donald M. Lambert Laboratory of Myeloma Genetics at the Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Blood (Impact Factor: 10.45). 03/2007; 109(6):2276-84. DOI: 10.1182/blood-2006-07-038430
Source: PubMed


To molecularly define high-risk disease, we performed microarray analysis on tumor cells from 532 newly diagnosed patients with multiple myeloma (MM) treated on 2 separate protocols. Using log-rank tests of expression quartiles, 70 genes, 30% mapping to chromosome 1 (P < .001), were linked to early disease-related death. Importantly, most up-regulated genes mapped to chromosome 1q, and down-regulated genes mapped to chromosome 1p. The ratio of mean expression levels of up-regulated to down-regulated genes defined a high-risk score present in 13% of patients with shorter durations of complete remission, event-free survival, and overall survival (training set: hazard ratio [HR], 5.16; P < .001; test cohort: HR, 4.75; P < .001). The high-risk score also was an independent predictor of outcome endpoints in multivariate analysis (P < .001) that included the International Staging System and high-risk translocations. In a comparison of paired baseline and relapse samples, the high-risk score frequency rose to 76% at relapse and predicted short postrelapse survival (P < .05). Multivariate discriminant analysis revealed that a 17-gene subset could predict outcome as well as the 70-gene model. Our data suggest that altered transcriptional regulation of genes mapping to chromosome 1 may contribute to disease progression, and that expression profiling can be used to identify high-risk disease and guide therapeutic interventions.

Download full-text


Available from: Michele Fox, Oct 02, 2015
22 Reads
    • "Multiple myeloma (MM) is a neoplasm of antibody-secreting plasma cells (PCs) and the second most frequently diagnosed hematopoietic malignancy (Barlogie et al., 2005). MM usually comprises several molecular subtypes with similar histological and clinical presentations (Hurt et al., 2004; Bergsagel et al., 2005; Carrasco et al., 2006; Gabrea et al., 2006; Zhan et al., 2006; Shaughnessy et al., 2007). Recent genome-wide sequencing (GWS) studies have revealed that MM genomes are mutated at the frequency of 2.9 per 10 6 bases (or, 7,450 nucleotide mutations per malignant cell), and most of these mutations occur in noncoding genomic sequences that make up >98% of the human genome (Chapman et al., 2011; Weinhold et al., 2014). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The growth and survival factor hepatocyte growth factor (HGF) is expressed at high levels in multiple myeloma (MM) cells. We report here that elevated HGF transcription in MM was traced to DNA mutations in the promoter alleles of HGF. Sequence analysis revealed a previously undiscovered single-nucleotide polymorphism (SNP) and crucial single-nucleotide variants (SNVs) in the promoters of myeloma cells that produce large amounts of HGF. The allele-specific mutations functionally reassembled wild-type sequences into the motifs that affiliate with endogenous transcription factors NFKB (nuclear factor kappa-B), MZF1 (myeloid zinc finger 1), and NRF-2 (nuclear factor erythroid 2-related factor 2). In vitro, a mutant allele that gained novel NFKB-binding sites directly responded to transcriptional signaling induced by tumor necrosis factor alpha (TNFα) to promote high levels of luciferase reporter. Given the recent discovery by genome-wide sequencing (GWS) of numerous non-coding mutations in myeloma genomes, our data provide evidence that heterogeneous SNVs in the gene regulatory regions may frequently transform wild-type alleles into novel transcription factor binding properties to aberrantly interact with dysregulated transcriptional signals in MM and other cancer cells. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
    Genes Chromosomes and Cancer 07/2015; 54(11). DOI:10.1002/gcc.22280 · 4.04 Impact Factor
  • Source
    • "SOD1 expression was also analyzed in MM patients treated under an NIH-sponsored clinical trial (UARK 98-026) utilizing induction regimen followed by melphalan-based tandem auto-transplantations, consolidation chemotherapy, and maintenance treatment. In this study, the 70- gene model was used to identify high-risk and low-risk group of MM patients where high-risk group comprised of patients with shorter durations of complete remission, overall survival (OS), and event-free survival (EFS) [24]. Cox proportional hazard models were used to estimate OS and EFS hazard ratios and 95% confidence interval (CI) for SOD1 as a continuous variable. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Multiple myeloma (MM) is an incurable B-cell malignancy. The proteasome inhibitor bortezomib (BTZ) is a frontline MM drug; however, intrinsic or acquired resistance to BTZ remains a clinical hurdle. As BTZ induces oxidative stress in MM cells, we queried if altered redox homeostasis promotes BTZ resistance. In primary human MM samples, increased gene expression of copper-zinc superoxide dismutase (CuZnSOD or SOD1) correlated with cancer progression, high-risk disease, and adverse overall and event-free survival outcomes. As an in vitro model, human MM cell lines (MM.1S, 8226, U266) and the BTZ-resistant (BR) lines (MM.1SBR, 8226BR) were utilized to determine the role of antioxidants in intrinsic or acquired BTZ-resistance. An up-regulation of CuZnSOD, glutathione peroxidase-1 (GPx-1), and glutathione (GSH) were associated with BTZ resistance and attenuated prooxidant production by BTZ. Enforced overexpression of SOD1 induced BTZ resistance and pharmacological inhibition of CuZnSOD with disulfiram (DSF) augmented BTZ cytotoxicity in both BTZ-sensitive and BTZ-resistant cell lines. Our data validates CuZnSOD as a novel therapeutic target in MM. We propose DSF as an adjuvant to BTZ in MM that is expected to overcome intrinsic and acquired BTZ resistance as well as augment BTZ cytotoxicity. Published by Elsevier B.V.
    11/2014; 4C:23-33. DOI:10.1016/j.redox.2014.11.002
  • Source
    • "As FISH proved useful in myeloma prognostication, studies began to assess whether gene expression profiling (GEP) could also be used effectively. Shaughnessy et al. first assessed 532 newly diagnosed myeloma patients with GEP and, using log-rank tests of expression quartiles, identified 70 genes which were linked to shorter durations of remission, event-free survival (EFS), and OS [14]. Interestingly, they found that 30% of these genes were mapped to chromosome 1, with the majority of upregulated genes on 1q and downregulated genes on 1p. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Molecular studies have shown that multiple myeloma is a highly genetically heterogonous disease which may manifest itself as any number of diverse subtypes each with variable clinicopathological features and outcomes. Given this genetic heterogeneity, a universal approach to treatment of myeloma is unlikely to be successful for all patients and instead we should strive for the goal of personalised therapy using rationally informed targeted strategies. Current DNA sequencing technologies allow for whole genome and exome analysis of patient myeloma samples that yield vast amounts of genetic data and provide a mutational overview of the disease. However, the clinical utility of this information currently lags far behind the sequencing technology which is increasingly being incorporated into clinical practice. This paper attempts to address this shortcoming by proposing a novel genetically based "traffic-light" risk stratification system for myeloma, termed the RAG (Red, Amber, Green) model, which represents a simplified concept of how complex genetic data may be compressed into an aggregate risk score. The model aims to incorporate all known clinically important trisomies, translocations, and mutations in myeloma and utilise these to produce a score between 1.0 and 3.0 that can be incorporated into diagnostic, prognostic, and treatment algorithms for the patient.
    09/2014; 2014:526568. DOI:10.1155/2014/526568
Show more