Clinical implications of t(11;14)(q13;q32), t(4;14)(p16.3;q32), and -17p13 in myeloma patients treated with high-dose therapy

Morie Gertz, Martha Lacy, Angela Dispenzieri, Philip R. Greipp, Mark R Litzow, Kimberly J. Henderson, Scott A. Van Wier, Greg J. Ahmann, Rafael Fonseca

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283 Scopus citations


Fluorescence in situ hybridization (FISH) is more sensitive than conventional cytogenetics for recognizing chromosomal changes. Several FISH-detected abnormalities have been associated with inferior prognosis, including deletion of chromosomes 17 and 13 (Δ13) and t(4;14)(p16.3;q32). We analyzed the prognostic value of FISH testing in 238 patients who received high-dose therapy between January 1990 and September 2001. All patients had pretransplantation cytoplasmic immunoglobulin FISH done on cytospin slides from bone marrow aspirates for t(11;14), t(4;14), and -17(p13.1) (TP53). Time to progression and overall survival were significantly shorter for patients with t(4;14) and those with -17(p13.1) but were not affected by t(11;14). Overall survival was significantly shorter for patients with both t(4;14) and Δ13 abnormalities than for those with Δ13 alone (26.8 vs 18.8 months). In a multivariable analysis of the effect of Δ13 and t(4;14), the risk ratio for t(4;14) was greater than for Δ13 (2.6 vs 1.5). For high-dose therapy patients, -17(p13) and t(4;14) have clinical importance for estimating time to progression and overall survival. The presence of t(4;14) identifies a subset of patients whose time to progression is only 8.2 months. These patients receive minimal benefit from autologous stem cell transplantation and are candidates for novel therapeutic approaches.

Original languageEnglish (US)
Pages (from-to)2837-2840
Number of pages4
Issue number8
StatePublished - Oct 2005


ASJC Scopus subject areas

  • Hematology

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