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Prepublished online as a Blood First Edition Paper on May 17, 2002; DOI 10.1182/blood-2002-03-0749.
Submitted March 15, 2002
Accepted April 19, 2002
Recurrent 14q32 translocations determine the prognosis of multiple myeloma, especially in patients receiving intensive chemotherapy
Philippe Moreau, Thierry Facon, Xavier Leleu, Nadine Morineau, Pauline Huyghe, Jean-Luc Harousseau, Regis Bataille, and Herve Avet-Loiseau*
Department of Hematology, University Hospital, Nantes, France
Department of Hematology, University Hospital, Lille, France
Hematology Laboratory, University Hospital, Nantes, France
* Corresponding author; email: havetloiseau{at}chu-nantes.fr.
Recently, we have described the biological correlations associated with the main translocations involving the 14q32 chromosomal region, i.e., t(14q32), in patients with multiple myeloma (MM). We have now extended the analysis to the prognostic value of these chromosomal rearrangements in 168 consecutive newly diagnosed patients receiving intensive chemotherapy within clinical trials of the IFM. Patients with t(4;14) displayed a poor outcome (short event free survival (EFS) and short overall survival (OS)), whereas those with t(11;14) displayed long survival. On the other hand, patients with neither t(4;14), nor t(11;14) presented an intermediate outcome. Importantly, chromosome 13 abnormalities (C13A) influence significantly the prognosis of this latter group. In contrast, C13A affected the outcome of the other patients in a much lesser extend, either because of an almost constant association (in the t(4;14) group), or because of a lack of any significant prognostic impact in the t(11;14) group (only one event in the 10 patients with t(11;14) and C13A). Considering that t(4;14) and t(11;14) (i) are the only (so far recognized) true recurrent t(14q32), (ii) are linked to specific Ig isotypes, and (iii) display specific outcomes, they represent distinct entities corresponding to a specific oncogenesis and prognosis. These data emphasized the interest to analyze these two translocations by fluorescence in situ hybridization in prospective therapeutic trials in order to consider these patients as distinct entities.
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