Deletion of 13q14 remains an independent adverse prognostic variable in multiple myeloma despite its frequent detection by interphase fluorescence in situ hybridization

Blood - Tập 95 Số 6 - Trang 1925-1930 - 2000
Niklas Zojer1, Robert Königsberg1, Jutta Ackermann1, E. Fritz1, Susanne Dallinger1, Elisabeth Krömer1, H Kaufmann1, Lucia Riedl1, Heinz Gisslinger1, S. Schreiber1, R. Heinz1, Heinz Ludwig1, H. Huber1, Johannes Drach1
1From the Department of Internal Medicine I, Division of Clinical Oncology, Division of Hematology and Hemostesiology, University of Vienna; Department of Internal Medicine I with Medical Oncology, Wilhelminenspital; Ludwig Boltzmann Institute for Leukemia Research and Hematology; and the Third Department of Internal Medicine, Hanuschspital, Vienna, Austria.

Tóm tắt

Abstract Interphase fluorescence in situ hybridization (FISH) studies of chromosomal region 13q14 were performed to investigate the incidence and clinical importance of deletions in multiple myeloma (MM). Monoallelic deletions of the retinoblastoma-1 (rb-1) gene and the D13S319 locus were observed in 48 of 104 patients (46.2%) and in 28 of 72 (38.9%) patients, respectively, with newly diagnosed MM. FISH studies found that 13q14 was deleted in all 17 patients with karyotypic evidence of monosomy 13 or deletion of 13q but also in 9 of 19 patients with apparently normal karyotypes. Patients with a 13q14 deletion were more likely to have stage III disease (P = .022), higher serum levels of β2-microglobulin (P = .059), and a higher percentage of bone marrow plasma cells (P = .085) than patients with a normal 13q14 status on FISH analysis. In patients with a deletion of 13q14, myeloma cell proliferation (Ki-67) was markedly increased (22.0% ± 6.9% compared with 15.6% ± 8.2% in patients without the deletion;P = .0008). Evaluation of bromodeoxyuridine incorporation in 5 patients revealed that both rb-1–deleted and rb-1–normal MM subpopulations were proliferative. The presence of a 13q14 deletion on FISH analysis was associated with a significantly lower rate of response to conventional-dose chemotherapy (40.8% compared with 78.6%; P = .009) and a shorter overall survival (24.2 months compared with > 60 months; P < .005) than in patients without the deletion. Multivariate analysis of prognostic factors confirmed the independent predictive value of 13q14 deletions for shortened survival. In conclusion, deletions of 13q14 are frequently detected by interphase FISH in patients with newly diagnosed MM, correlate with increased proliferative activity, and represent an independent adverse prognostic feature in MM.

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Tài liệu tham khảo

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Blood

Tập 95 Số 6

1925-1930

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