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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.

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Submitted April 6, 2005
Accepted June 10, 2005

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

Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
Division of Hematology/Oncology, Mayo Clinic, Scottsdale, Arizona, USA

* Corresponding author; email: gertz.morie{at}mayo.edu.

Fluorescent 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 ({Delta}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 pretransplant cytoplasmic immunoglobulin FISH done on cytospin slides from bone marrow aspirates for t(11;14), t(4;14), and -17(p13.1) (p53). 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 {Delta}13 abnormalities than for those with {Delta}13 alone (26.8 vs 18.8 months). In a multivariable analysis of the effect of {Delta}13 and t(4;14), the risk ratio for t(4;14) was greater than for {Delta}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.


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