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Blood, 1 October 2001, Vol. 98, No. 7, pp. 2229-2238
NEOPLASIA
Hypodiploidy is a major prognostic factor in multiple
myeloma
Nicole Véronique Smadja,
Christian Bastard,
Christophe Brigaudeau,
Dominique Leroux, and
Christophe Fruchart on behalf of the Groupe
Français de Cytogénétique
Hématologique
From the Research Cytogenetic Laboratory,
Hôpital Saint-Antoine, Paris; Genetic Laboratory, INSERM EMI9906,
IFRMP23, Centre Henri Becquerel, Rouen; Hematology Laboratory,
Hôpital Universitaire Dupuytren, Limoges; Onco-Hematology Genetic
Laboratory, Centre Hospitalier Universitaire, Grenoble; Hematology
Department, Hôpital Jacques Monod, Le Havre, France.
Conventional karyotypes performed before any treatment in 208 patients with multiple myeloma were reviewed by the Groupe
Français de Cytogénétique Hématologique. A
total of 138 patients displayed complex chromosomal abnormalities
(CCAs). According to the chromosome number pattern, a first group of 75 patients had a hyperdiploid karyotype. A second group of 63 patients
referred to as the hypodiploid group had either pseudodiploid,
hypodiploid, or near-tetraploid karyotypes. Of 159 treated patients
available for survival analysis, 116 had an abnormal karyotype. The
comparison of overall survival (OS) between hyperdiploid and
hypodiploid patients showed a highly significant difference (median OS
33.8 vs 12.6 months, respectively, P < .001). The
presence of 14q32 rearrangements (36 of 116 patients) worsened the
prognosis (median OS 17.6 vs 29.9 months, P < .02). The
presence of chromosome 13q abnormalities (13qA, 63 patients) did not
modify OS in CCA patients (median OS 20.6 vs 27.8 months, P < .59). However, taking into account the whole series
including normal karyotypes, 13qA (63 of 159 patients) had a
significant impact on OS (median 20.6 vs 37.1 months,
P < .04). In the same way, the presence of a hypodiploid
karyotype (52 of 159 patients) had a strong prognostic value (OS 12.8 vs 44.5 months, P < .000 01). A multivariate analysis
including stage,  2-microglobulin, bone marrow
plasmocytosis, treatment type, 13qA, and hyperdiploidy and hypodiploidy
showed that a hypodiploid karyotype was the first independent factor
for OS (P < .001), followed by treatment approach. These
results confirm that the chromosome number pattern of malignant plasma
cells is a very powerful prognostic factor in newly diagnosed multiple
myeloma patients.
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