Implications of MYC rearrangements in newly diagnosed multiple myeloma

Nadine Abdallah, Linda B. Baughn, S. Vincent Rajkumar, Prashant Kapoor, Morie A. Gertz, Angela Dispenzieri, Martha Q. Lacy, Suzanne R. Hayman, Francis K. Buadi, David Dingli, Ronald S. Go, Yi L. Hwa, Amie Fonder, Miriam Hobbs, Yi Lin, Nelson Leung, Taxiarchis Kourelis, Rahma Warsame, Mustaqeem Siddiqui, John LustRobert A. Kyle, Rhett Ketterling, Leif Bergsagel, Patricia Greipp, Shaji K. Kumar

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Rearrangements involving the MYC protooncogene are common in newly diagnosed multiple myeloma, but their prognostic significance is still unclear. The purpose of this study was to assess the impact of MYC rearrangement on clinical characteristics, treatment response, and survival in patients with newly diagnosed multiple myeloma. Experimental Design: This is a retrospective study including 1,342 patients seen in Mayo Clinic in Rochester, MN, from January 2006 to January 2018, who had cytogenetic testing by FISH at diagnosis, including MYC testing using the break apart FISH probe (8q24.1). Results: A rearrangement involving MYC was found in 8% of patients and was associated with elevated b2-microglobulin, ≥50% bone marrow plasma cells, IgA multiple myeloma, and the cooccurrence of trisomies. There were no differences in overall response rates between patients with and without MYC rearrangement when induction chemotherapy was proteasome inhibitor (PI)-based, immunomodulatory drug (IMiD)based or PI þ IMiD-based. Overall survival was shorter in patients with MYC rearrangement compared with patients without MYC rearrangement (5.3 vs. 8.0 years, P < 0.001). MYC rearrangement was associated with increased risk of death on multivariate analysis when high-risk cytogenetic abnormalities, ISS stage III, and ≥70 years of age were included (risk ratio: 1.5; P ¼ 0.007). Conclusions: MYC rearrangement is associated with high disease burden and is an independent adverse prognostic factor in patients with newly diagnosed multiple myeloma.

Original languageEnglish (US)
Pages (from-to)6581-6588
Number of pages8
JournalClinical Cancer Research
Volume26
Issue number24
DOIs
StatePublished - Dec 2020

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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