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Blood, 15 October 2005, Vol. 106, No. 8, pp. 2837-2840.
Prepublished online as a Blood First Edition Paper on June 23, 2005; DOI 10.1182/blood-2005-04-1411.
 Previous Article | Table of Contents | Next Article 
NEOPLASIA
Clinical implications of t(11;14)(q13;q32), t(4;14)(p16.3;q32), and -17p13 in myeloma patients treated with high-dose therapy
Morie A. Gertz,
Martha Q. Lacy,
Angela Dispenzieri,
Philip R. Greipp,
Mark R. Litzow,
Kimberly J. Henderson,
Scott A. Van Wier,
Greg J. Ahmann, and
Rafael Fonseca
From the Division of Hematology, Mayo Clinic, Rochester, MN; and the Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ.
Fluorescence in situ hybridization (FISH) is more sensitive than conventional cytogenetics for recognizing chromosomal changes. Several FISH-detected abnormalities have been associated with inferior prognosis, including deletion of chromosomes 17 and 13 ( 13) and t(4;14)(p16.3;q32). We analyzed the prognostic value of FISH testing in 238 patients who received high-dose therapy between January 1990 and September 2001. All patients had pretransplantation cytoplasmic immunoglobulin FISH done on cytospin slides from bone marrow aspirates for t(11;14), t(4;14), and -17(p13.1) (TP53). Time to progression and overall survival were significantly shorter for patients with t(4;14) and those with -17(p13.1) but were not affected by t(11;14). Overall survival was significantly shorter for patients with both t(4;14) and 13 abnormalities than for those with 13 alone (26.8 vs 18.8 months). In a multivariable analysis of the effect of 13 and t(4;14), the risk ratio for t(4;14) was greater than for 13 (2.6 vs 1.5). For high-dose therapy patients, -17(p13) and t(4;14) have clinical importance for estimating time to progression and overall survival. The presence of t(4;14) identifies a subset of patients whose time to progression is only 8.2 months. These patients receive minimal benefit from autologous stem cell transplantation and are candidates for novel therapeutic approaches. (Blood. 2005;106:2837-2840)
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