Journal of Blood Disorders & Transfusion

Prognosis and response to therapy can be efficiently predicted by a combination of cytogenetic aberrations, detected by interphase-FISH in newly diagnosed multiple myeloma patients

Hematologists Global Summit 2018

July 13-14, 2018 Sydney, Australia

Hemani Jain, Dhanlaxmi Shetty, Yogita Deshpande, Manju Sengar, Navin Khattry, Hasmukh Jain, Bhausaheb Bagal and P G Subramanian

Advanced Centre for Treatment, Research & Education in Cancer, Tata Memorial Centre, India

Posters & Accepted Abstracts: J Blood Disord Transfus

Abstract:

Introduction: The detection and interpretation of cytogenetic abnormalities in Multiple Myeloma is of critical importance for prognosis and risk stratification. Objectives: To determine the role of cytogenetic aberrations in classification, risk stratification and predicting therapy response. Material & Methods: FISH studies using commercially available DNA probes were retrospectively carried out in 342 de novo multiple myeloma patients on purified CD138 positive plasma cells. Results: Cytogenetic abnormalities by FISH were detected in 65% (221/342) patients. The incidences of aberrations were monosomy 13/del (13q) in 35% hyper-diploidy in 33%, IgH translocations in 30%, gain (1q21) in 21% and monosomy 17/TP53 deletion in 7% patients. Patients�?? median age was 55.5 years (range, 27 to 84 years) with male preponderance. IgH translocation group (P<0.042) and TP53 deletion (P<0.052) were identified as high-risk group due to correlation with advanced disease, ISS stage III, whereas chromosome 13 aberrations were associated with high plasma cells (P<0.043). Lower response rates were observed in patients with high risk cytogenetic abnormalities: t (4; 14) (P<0.008), t (14; 20) (P<0.032) and gain (1q) (P<0.003). Median survival can be commented on further follow up. Conclusions: Lower Incidence of chromosome 13 aberrations, t (11; 14) and lower median age, as compared to Western population, is probably due to geographic heterogeneity. Deletion (17p13), t (4; 14), t (14; 20) and gain (1q21) were independent high-risk prognostic factors, can predict lower response rates to therapy, are more likely to relapse early, thus need more intensive treatments. Interphase-FISH can efficiently detect poor prognostic markers thus helping in risk stratification aiding in treatment decisions and better patient management.