Predictive role of interphase cytogenetics for survival of patients with multiple myeloma

Purpose: Recent metaphase cytogenetic studies suggested that specific chrom osomal abnormalities are of prognostic significance in patients with multip le myeloma (MM). Because the true incidence of chromosomal abnormalities in MM is much higher than that detected by metaphase analysis, we used interp hase fluorescence in situ hybridization (FISH) to determine the prognostic value of specific chromosomal aberrations. Patients and Methods: Bone marrow plasma cells from 89 previously untreated patients with MM were studied consecutively by FISH to detect the deletion s of 13q14, 17p13, and 11q and the presence of t(11;14)(q13;q32). FISH resu lts were analyzed in the context of clinical parameters (response to treatm ent and survival after conventional-dose chemotherapy), and a multivariate analysis of prognostic factors was performed. Results: By FISH, the deletion of 13q14 occurred in 40 patients (44.9%), de letion of 17p13 in 22 (24.7%), and 11q abnormalities in 14(15.7%; seven wit h t(ll; 14)). Deletions of 13q14 and 17q13 were associated with poor respon se to induction treatment (46.9% v 77.3% in those without deletions, P = .0 06 and 40.0% v 73.2%, P = .008, respectively) and short median overall surv ival (OS) time (24.2 v 88.1 months, P = .008 and 16.2 v 51.3 months, P = .0 08, respectively). Short median OS time was also observed for patients with 11q abnormalities (13.1 v 41.6 months, P = .02). According to the number o f unfavorable cytogenetic features (deletion of 13q14, deletion of 17q13, a nd aberrations of 11q) that were present in each patient (0 v 1 v 2 or 3), patients with significantly different OS times could be discriminated from one another (102.4 v 29.6 v 13.9 months, P < .001, respectively). Conclusion: For patients with MM who were treated with conventional-dose ch emotherapy, interphase FISH for 13q14, 17q13, and 11q provides prognostical ly relevant information in addition to that provided by standard prognostic factors. This observation may be considered for risk-adopted stratificatio ns of MM patients in future clinical trials. (C) 2000 by American Society o f Clinical Oncology.