Certain trisomies, when there are 3 instances of a particular chromosome instead of 2, significantly improve overall survival in patients with multiple myeloma with del(17p) or t(4;14) genetic mutations, while the trisomy that causes Down’s syndrome was found to worsen overall survival, a new study published online ahead of print in the journal Blood has shown.1
Although del(17p) and t(4;14) are the major abnormalities that drive poor outcomes in patients with multiple myeloma, the outcome of these high-risk patients is not always consistent. Some patients may display long survival.
Therefore, researchers sought to identify concomitant “good risk” chromosomal changes that might improve outcomes in these patients.
For the study, researchers analyzed data from 965 patients with multiple myeloma, including 168 with t(4;14) and 126 patients with del(17p). As hypothesized, researchers found that trisomic chromosomes were highly associated with survival.
Results showed that trisomy 3 improved time to progression and trisomies 3 and/or 5 significantly improved overall survival in patients with multiple myeloma, while trisomy 21 worsened overall survival.
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The study demonstrated that in patients with t(4;14) especially, trisomies 3 and/or 5 appeared to overcome the poor prognosis in these high-risk patients.
“This finding could be important for routine assessment of prognosis in myeloma, some high-risk patients with a traditional evaluation could be in fact standard risk,” the authors concluded.
- Chretien M-L, Corre J, Lauwers-Cances V, et al. Understanding the role of hyperdiploidy in myeloma prognosis: which trisomies really matter? [published online ahead of print October 29, 2015]. Blood. doi: 10.1182/blood-2015-06-650242.