Cytogenetics and Survival of Multiple Myeloma: Isolated and Combined Effects.

BACKGROUND: A variety of clinical and laboratory prognostic factors for multiple myeloma (MM) have been addressed in published studies. The prognostic significance of cytogenetic abnormalities is also under investigation.

PATIENTS AND METHODS: The present study evaluated the potential prognostic role of cytogenetic events and their combinations in terms of overall survival in a large cohort of unselected patients with MM (n = 432). Multivariate Cox regression analysis was performed, adjusting for age, gender, Chronic Kidney Disease Epidemiology Collaboration Kidney Disease: Improving Global Outcomes classification, International Staging System score, Eastern Cooperative Oncology Group performance status, serum lactate dehydrogenase, serum calcium, platelet count, and blood hemoglobin.

RESULTS: The presence of del(13q) (adjusted hazard ratio [HR], 1.71; 95% confidence interval [CI], 1.18-2.47), t(4;14) (adjusted HR, 2.00; 95% CI, 1.19-3.35), and/or del(17p) (adjusted HR, 2.03; 95% CI, 1.22-3.37) was independently associated with poorer overall survival. The poor prognosis seemed more pronounced among patients harboring combinations of 2 adverse cytogenetic abnormalities. In contrast, t(14;16), t(11;14), and add(1q21) were not associated with overall survival. The effect of bortezomib seemed rather minimal in the modification of the prognostic role mediated by del(17p).

CONCLUSION: The presence of del(13q), t(4;14), and del(17p), singly or in combination, seems to be an independent poor prognostic factor for patients with MM.