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.
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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.
Reference
- 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.
