Abstract
In myeloma, the prognostic impact of different strategies used to detect chromosome 13 deletion (Δ13) remains controversial. To address this, we compared conventional cytogenetics and interphase fluorescence in situ hybridization (iFISH) in a large multicenter study (n=794). The ability to obtain abnormal metaphases was associated with a poor prognosis, which was worse if Δ13, p53 deletion or t(4;14) was present, but only Δ13 remained significant on multivariate analysis. Patients with Δ13, by either cytogenetics or iFISH, had a poor prognosis. However, when cases with Δ13 detectable by both cytogenetics and iFISH were separated from those detected by iFISH only, the poor prognosis of iFISH-detectable Δ13 disappeared; their outcome matched that of patients with no detectable Δ13 (P=0.115). Addition of ploidy status to iFISH-Δ13 did not affect the prognostic value of the test. Indeed both cytogenetics and iFISH Δ13 divided both hyperdiploidy and nonhyperdiploidy into two groups with similar prognoses, indicating that the poor prognosis of ploidy is entirely due to its association with Δ13. We conclude that Δ13 detected by metaphase analysis is a critical prognostic factor in myeloma. Absence of Δ13, even in those patients yielding only normal or no metaphases, is associated with a relatively good prognosis.
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Acknowledgements
We are grateful to Leukaemia Research for funding this work. We thank Paul Strike of the Salisbury District Hospital Research and Development Support Unit for help with the statistical analysis, Anthony Moorman for helpful discussions and Andy Rawstron and Roger Owen from the Haematological Malignancy Diagnostic Unit in Leeds for information helpful towards making the diagnosis in some patients. Laura Chiecchio performed research, analysed data and wrote the first draft of the paper; Rebecca KM Protheroe, Ashraf H Ibrahim, Kan Luk Cheung, Christina Rudduck, Gian Paolo Dagrada, Elisabet Dachs Cabanas, Tim Parker, Mathew Nightingale and Ashutosh Wechalekar performed research; Kim H Orchard, Christine J Harrison, Nicholas CP Cross and Gareth J Morgan contributed to the analysis of the data; Fiona M Ross designed and performed research, analysed data. All the authors contributed to the final draft of the paper.
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Chiecchio, L., Protheroe, R., Ibrahim, A. et al. Deletion of chromosome 13 detected by conventional cytogenetics is a critical prognostic factor in myeloma. Leukemia 20, 1610–1617 (2006). https://doi.org/10.1038/sj.leu.2404304
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DOI: https://doi.org/10.1038/sj.leu.2404304
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