Translocation t(11;14) and survival of patients with light chain (AL) amyloidosis

Alan H Bryce, Rhett P. Ketterling, Morie Gertz, Martha Lacy, Ryan A. Knudson, Steven Zeldenrust, Shaji K Kumar, Suzanne Hayman, Francis Buadi, Robert A. Kyle, Philip R. Greipp, John A. Lust, Stephen J Russell, S Vincent Rajkumar, Rafael Fonseca, Angela Dispenzieri

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Background Light chain amyloidosis is a rare plasma cell dyscrasia. Interphase fluorescence in situ hybridization (FISH) coupled to cytoplasmic staining of specific Ig (clg-FISH) on bone marrow plasma cells has become well established in the initial evaluation of multiple myeloma, a related disorder. Little, however, is known about cytogenetic abnormalities in patients with light chain amyloidosis. Design and Methods We reviewed 56 patients with light chain amyloidosis who had clg-FISH performed as part of their routine clinical testing using the standard screening panel employed in multiple myeloma at our institution. Results Seventy percent of patients had abnormal clg-FISH, with the most common abnormalities being IgH translocations [48%] - including t(ll;14) [39%], and t(14;16) [2%] - and dell3/dell3q [30%]. No t(4;14) or deletions of 17p (p53) were observed. Patients with t(ll;14) had the lowest levels of clonal plasma cells, and those with dell3 had the highest. The risk of death for patients harboring the t(ll;14) translocation was 2.1 (CI 1.04-6.4), which on multivariate analysis was independent of therapy. Conclusions Although preliminary, our data would suggest that clg-FISH testing is important in patients with light chain amyloidosis and that t(ll;14) is an adverse prognostic factor in these patients.

Original languageEnglish (US)
Pages (from-to)380-386
Number of pages7
JournalHaematologica
Volume94
Issue number3
DOIs
StatePublished - Mar 2009

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Amyloidosis
Fluorescence In Situ Hybridization
Light
Survival
Plasma Cells
Multiple Myeloma
Paraproteinemias
Interphase
Chromosome Aberrations
Bone Marrow Cells
Multivariate Analysis
Staining and Labeling

Keywords

  • Amyloidosis
  • Clg-fish
  • T(11;14)

ASJC Scopus subject areas

  • Hematology

Cite this

Translocation t(11;14) and survival of patients with light chain (AL) amyloidosis. / Bryce, Alan H; Ketterling, Rhett P.; Gertz, Morie; Lacy, Martha; Knudson, Ryan A.; Zeldenrust, Steven; Kumar, Shaji K; Hayman, Suzanne; Buadi, Francis; Kyle, Robert A.; Greipp, Philip R.; Lust, John A.; Russell, Stephen J; Rajkumar, S Vincent; Fonseca, Rafael; Dispenzieri, Angela.

In: Haematologica, Vol. 94, No. 3, 03.2009, p. 380-386.

Research output: Contribution to journalArticle

Bryce, Alan H ; Ketterling, Rhett P. ; Gertz, Morie ; Lacy, Martha ; Knudson, Ryan A. ; Zeldenrust, Steven ; Kumar, Shaji K ; Hayman, Suzanne ; Buadi, Francis ; Kyle, Robert A. ; Greipp, Philip R. ; Lust, John A. ; Russell, Stephen J ; Rajkumar, S Vincent ; Fonseca, Rafael ; Dispenzieri, Angela. / Translocation t(11;14) and survival of patients with light chain (AL) amyloidosis. In: Haematologica. 2009 ; Vol. 94, No. 3. pp. 380-386.
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abstract = "Background Light chain amyloidosis is a rare plasma cell dyscrasia. Interphase fluorescence in situ hybridization (FISH) coupled to cytoplasmic staining of specific Ig (clg-FISH) on bone marrow plasma cells has become well established in the initial evaluation of multiple myeloma, a related disorder. Little, however, is known about cytogenetic abnormalities in patients with light chain amyloidosis. Design and Methods We reviewed 56 patients with light chain amyloidosis who had clg-FISH performed as part of their routine clinical testing using the standard screening panel employed in multiple myeloma at our institution. Results Seventy percent of patients had abnormal clg-FISH, with the most common abnormalities being IgH translocations [48{\%}] - including t(ll;14) [39{\%}], and t(14;16) [2{\%}] - and dell3/dell3q [30{\%}]. No t(4;14) or deletions of 17p (p53) were observed. Patients with t(ll;14) had the lowest levels of clonal plasma cells, and those with dell3 had the highest. The risk of death for patients harboring the t(ll;14) translocation was 2.1 (CI 1.04-6.4), which on multivariate analysis was independent of therapy. Conclusions Although preliminary, our data would suggest that clg-FISH testing is important in patients with light chain amyloidosis and that t(ll;14) is an adverse prognostic factor in these patients.",
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AU - Ketterling, Rhett P.

AU - Gertz, Morie

AU - Lacy, Martha

AU - Knudson, Ryan A.

AU - Zeldenrust, Steven

AU - Kumar, Shaji K

AU - Hayman, Suzanne

AU - Buadi, Francis

AU - Kyle, Robert A.

AU - Greipp, Philip R.

AU - Lust, John A.

AU - Russell, Stephen J

AU - Rajkumar, S Vincent

AU - Fonseca, Rafael

AU - Dispenzieri, Angela

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N2 - Background Light chain amyloidosis is a rare plasma cell dyscrasia. Interphase fluorescence in situ hybridization (FISH) coupled to cytoplasmic staining of specific Ig (clg-FISH) on bone marrow plasma cells has become well established in the initial evaluation of multiple myeloma, a related disorder. Little, however, is known about cytogenetic abnormalities in patients with light chain amyloidosis. Design and Methods We reviewed 56 patients with light chain amyloidosis who had clg-FISH performed as part of their routine clinical testing using the standard screening panel employed in multiple myeloma at our institution. Results Seventy percent of patients had abnormal clg-FISH, with the most common abnormalities being IgH translocations [48%] - including t(ll;14) [39%], and t(14;16) [2%] - and dell3/dell3q [30%]. No t(4;14) or deletions of 17p (p53) were observed. Patients with t(ll;14) had the lowest levels of clonal plasma cells, and those with dell3 had the highest. The risk of death for patients harboring the t(ll;14) translocation was 2.1 (CI 1.04-6.4), which on multivariate analysis was independent of therapy. Conclusions Although preliminary, our data would suggest that clg-FISH testing is important in patients with light chain amyloidosis and that t(ll;14) is an adverse prognostic factor in these patients.

AB - Background Light chain amyloidosis is a rare plasma cell dyscrasia. Interphase fluorescence in situ hybridization (FISH) coupled to cytoplasmic staining of specific Ig (clg-FISH) on bone marrow plasma cells has become well established in the initial evaluation of multiple myeloma, a related disorder. Little, however, is known about cytogenetic abnormalities in patients with light chain amyloidosis. Design and Methods We reviewed 56 patients with light chain amyloidosis who had clg-FISH performed as part of their routine clinical testing using the standard screening panel employed in multiple myeloma at our institution. Results Seventy percent of patients had abnormal clg-FISH, with the most common abnormalities being IgH translocations [48%] - including t(ll;14) [39%], and t(14;16) [2%] - and dell3/dell3q [30%]. No t(4;14) or deletions of 17p (p53) were observed. Patients with t(ll;14) had the lowest levels of clonal plasma cells, and those with dell3 had the highest. The risk of death for patients harboring the t(ll;14) translocation was 2.1 (CI 1.04-6.4), which on multivariate analysis was independent of therapy. Conclusions Although preliminary, our data would suggest that clg-FISH testing is important in patients with light chain amyloidosis and that t(ll;14) is an adverse prognostic factor in these patients.

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