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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.
Submitted December 30, 2003
Accepted February 13, 2004
Deletion of chromosome 13q14 detected by fluorescence in situ hybridization as prognostic factor following allogeneic dose-reduced stem cell transplantation in patients with multiple myeloma
Nicolaus Kroger*, 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
Bone Marrow Transplantation, University Hospital, Hamburg, Germany
Hematology/Oncology, University Hospital, Hamburg, Germany
Hematology/Oncology, University Hospital, Tuebingen, Germany
Hematology/Oncology, University Hospital, Ulm, Germany
Hematology/Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel Hashomer, Israel
Hematology/Oncology, University Hospital, Salamanca, Spain
Hematology/Oncology, Community Hospital, Idar-Oberstein, Germany
Bone Marrow Transplantation, DKD-Cinic, Wiesbaden, Germany
Bone Marrow Transplantation, Community-Hospital, Nuernberg, Germany
Hematology/Oncology, University Hospital, Jena, Germany
Bone Marrow Transplantation, Rush-Presbyterian St Luke's Medical Center, Chicago, Illinois, USA
WISP, Research Institute, Langenfeld, Germany
* Corresponding author; email: nkroeger{at}uke.uni-hamburg.de.
We investigated in a retrospective multicenter study the impact of deletion 13q by fluorescence in situ hybridization (FISH) on outcome after dose-reduced allografting in patients with multiple myeloma. In 68 out of 140 patients data on deletion 13q detected by FISH were available: 37 patients were FISH negative and 31 FISH positive for deletion 13q14. Patients in both groups were well balanced regarding age,  2-microglobulin, relapse after a prior autograft, donor sex, related and unrelated donor, graft source, CD34+ cell dose, and chemosensitivity at time of transplantation. Patients with deletion 13 had a worse event-free survival and overall survival than patients without deletion 13 (18% vs 42%, p=0.05 and 18% vs 67% p=0.03, respectively). Patients with deletion 13 experienced a higher relapse rate
(82% vs 58%, p=0.05), but similar incidence of treatment related mortality at one year (24% vs 18%). In the multivariate analysis, deletion 13q remained a significant risk factor for higher relapse-rate (HR 3.28; 95% CI: 1.31-8.24; p=0.01) and for event-free survival (HR 1.94; 95% CI: 1.03-3.67; p=0.04). Concerning overall survival, two or more prior high-dose chemotherapies were associated with a significant higher probabilty of dying (HR: 2.48 ; 95% CI: 1.19-5.17, p=0.02), while patients with deletion 13q had a nearly two times higher risk of non surviving (HR: 1.94; 95% CI: 0.95-3.98, p=0.07) after dose-reduced allogeneic stem cell transplantation.
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