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Blood, 1 September 2006, Vol. 108, No. 5, pp. 1724-1732.
Prepublished online as a Blood First Edition Paper on May 16, 2006; DOI 10.1182/blood-2006-03-009910.
Previous Article | Next Article 
Submitted March 15, 2006
Accepted April 25, 2006
Frequent gain of chromosome band 1q21 in plasma cell dyscrasias detected by fluorescence in situ hybridization: Incidence increases from MGUS to relapsed myeloma and is related to prognosis and disease progression following tandem stem cell transplantation
Ichiro Hanamura, James P Stewart, Yongsheng Huang, Fenghuang Zhan, Madhumita Santra, Jeffery R Sawyer, Klaus Hollmig, Maurizio Zangarri, Mauricio Pineda-Roman, Frits van Rhee, Federica Cavall, Bart Burington, John Crowley, Guido Tricot, Bart Barlogie, and John D Shaughnessy Jr.*
Donna D. and Donald M. Lambert Lab., University of Arkansas for Medical Sciences, Little Rock,AR,USA
University of Arkansas for the Medical Sciences
University of Arkansas for Medical Sciences
Cancer Research and Biostatistics, Seattle, WA, USA
* Corresponding author; email: shaughnessyjohn{at}uams.edu.
Using fluorescence in situ hybridization we investigated amplification of chromosome band 1q21 (Amp1q21) in over 500 untreated patients with monoclonal gammopathy of undetermined significance (MGUS, n=14), smoldering multiple myeloma (SMM, n=31) and newly diagnosed MM (n=479) as well as 45 relapsed MM. The frequency of Amp1q21 was 0% in MGUS, 45% in SMM, 43% in newly diagnosed MM and 72% in relapsed MM (newly diagnosed vs. relapsed MM, P<0.0001). Amp1q21 was detected in 10 of 12 patients who evolved to active MM compared to 4 of 19 who remained SMM (P<0.001). Newly diagnosed MM with Amp1q21 had inferior 5- year event- free/overall survival compared with those lacking Amp1q21 (38%/52% vs. 62%/78%, both, P<0.0001). Thalidomide improved 5-year EFS in patients lacking Amp1q21 but not in those with Amp1q21, P=0.0044). Multivariate analysis including other major predictors revealed that Amp1q21 was an independent poor prognostic factor. Relapsed patients who had Amp1q21 at relapse had inferior 5-year post-relapse survival compared with those lacking Amp1q21 at relapse (15% vs. 53%, P=0.0271). The proportion of cells with Amp1q21 and the copy number of 1q21 tended to increase at relapse compared with diagnosis. Our data suggest that Amp1q21 is associated with both disease progression and poor prognosis.

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