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Blood, 1 June 2004, Vol. 103, No. 11, pp. 4056-4061.
Prepublished online as a Blood First Edition Paper on February 24, 2004; DOI 10.1182/blood-2003-12-4435.
 Previous Article | Table of Contents | Next Article 
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Deletion of chromosome band 13q14 as detected by fluorescence in situ hybridization is a prognostic factor in patients with multiple myeloma who are receiving allogeneic dose-reduced stem cell transplantation
Nicolaus Kröger,
Georgia Schilling,
Hermann Einsele,
Peter Liebisch,
Avichai Shimoni,
Arnon Nagler,
Jose A. Perez-Simon,
Jesus F. San Miguel,
Michael Kiehl,
Axel Fauser,
Rainer Schwerdtfeger,
Hannes Wandt,
Herbert G. Sayer,
Han Myint,
Hans Klingemann,
Tatjana Zabelina,
Judith Dierlamm,
Axel Hinke, and
Axel R. Zander
From the Department of Bone Marrow Transplantation, University Hospital, Hamburg, Germany; Department of Oncology and Haematology, University Hospital, Hamburg, Germany; Department of Haematology and Oncology, University Hospital, Tübingen, Germany; Department of Internal Medicine III, University Hospital, Ulm, Germany; Department of Haematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel Hashomer, Israel; Hospital Clinico Universitario, Salamanca, Spain; Department of Oncology and Haematology and Bone Marrow Transplantation (BMT), Idar-Oberstein, Germany; Department of Bone Marrow Transplantation, DKD-Clinic, Wiesbaden, Germany; Department of Bone Marrow Transplantation, Nürnberg, Germany; Department of Oncology and Hematology, University Hospital, Jena, Germany; Department of Bone Marrow Transplantation, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL; and Statistic Research Institute, Langenfeld, Germany.
We investigated in a retrospective multicenter study the impact of chromosome arm 13q deletion (13q-) as detected by fluorescence in situ hybridization (FISH) on outcome after dose-reduced allografting in patients with multiple myeloma. In 68 of 140 patients, data on chromosome 13q status were available. Most patients included had advanced myeloma. At 2 years, patients with 13q deletion (n = 31) had a shorter event-free (18% vs 42%; P = .05) and overall survival (18% vs 67%; P = .03) than patients without 13q- (n = 37). Patients with 13q- experienced a higher relapse rate (77% vs 44%; P < .001) but a similar incidence of transplantation-related mortality at one year (24% vs 18%). In a multivariate analysis, 13q- remained a significant risk factor for a higher relapse rate (hazard ratio [HR], 3.28; 95% confidence interval [CI], 1.31-8.24; P = .01) and a shorter event-free survival (HR, 1.94; 95% CI, 1.03-3.67; P = .04). Concerning overall survival, 2 or more cycles of prior high-dose chemotherapy were associated with a significantly higher probability of death (HR, 2.48; 95% CI, 1.19-5.17; P = .02), while patients with deletion 13q had a nearly 2 times higher risk of death (HR, 1.94; 95% CI, 0.95-3.98; P = .07) after dose-reduced allogeneic stem cell transplantation.
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