Abnormal cytogenetics predict poor survival after high-dose therapy and autologous blood cell transplantation in multiple myeloma

We compared the prognostic value of conventional cytogenetic analysis and e stablished factors such as beta(2)-microglobulin and plasma cell labeling i ndex in 70 patients undergoing autologous blood cell transplantation for mu ltiple myeloma, Patients underwent transplantation 5 to 88 months (median, 20 months) after the initial diagnosis of myeloma, Factors studied mere age , sex, beta(2)-microglobulin, response to prior therapy, plasma cell labeli ng index, cytogenetic analysis, bone marrow plasma cell percentage, lactate dehydrogenase and C-reactive protein, Twenty-eight of 65 patients (43%) ha d abnormal marrow cytogenetics, Overall survival measured from transplantat ion was significantly better in patients with normal cytogenetics than in t hose with abnormal cytogenetics (median survival, 25 vs 12 months, P = 0.00 3), Progression-free survival was better, with median times of 12 vs 7 mont hs, respectively (P = 0.005); overall survival measured from the time myelo ma was first diagnosed was also longer, with median survivals of 62 and 39 months, respectively (P = 0.001). Median plasma cell labeling index was 1.5 % in patients with abnormal cytogenetics and 0.2% in those with normal cyto genetics (P < 0.001), Abnormal bone marrow cytogenetics predict poor surviv al after blood cell transplantation for myeloma, There is a significant cor relation between abnormal cytogenetics and high plasma cell labeling index, suggesting that certain cytogenetic abnormalities may offer a proliferativ e advantage to myeloma cells.