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Chromosomal aberrations +1q21 and del(17p13) predict survival in patients with recurrent multiple myeloma treated with lenalidomide and dexamethasone

  1. Ulrike Klein MD1,
  2. Anna Jauch PhD2,
  3. Thomas Hielscher3,
  4. Jens Hillengass MD1,
  5. Marc S. Raab MD1,
  6. Anja Seckinger MD1,
  7. Dirk Hose MD1,
  8. Anthony D. Ho MD1,
  9. Hartmut Goldschmidt MD1,4,
  10. Kai Neben MD1,†,*

Article first published online: 4 DEC 2010

DOI: 10.1002/cncr.25775

Issue

Cancer

Cancer

Volume 117, Issue 10, pages 2136–2144, 15 May 2011

Additional Information

How to Cite

Klein, U., Jauch, A., Hielscher, T., Hillengass, J., Raab, M. S., Seckinger, A., Hose, D., Ho, A. D., Goldschmidt, H. and Neben, K. (2011), Chromosomal aberrations +1q21 and del(17p13) predict survival in patients with recurrent multiple myeloma treated with lenalidomide and dexamethasone. Cancer, 117: 2136–2144. doi: 10.1002/cncr.25775

Author Information

  1. 1

    Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany

  2. 2

    Institute for Human Genetics, University of Heidelberg, Heidelberg, Germany

  3. 3

    Department of Biostatistics, German Cancer Research Center, Heidelberg, Germany

  4. 4

    National Center for Tumor Diseases, Heidelberg, Germany

  1. †

    Fax: (011) 49-6221-56-5721

*Department of Internal Medicine V, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany

Publication History

  1. Issue published online: 26 APR 2011
  2. Article first published online: 4 DEC 2010
  3. Manuscript Accepted: 5 OCT 2010
  4. Manuscript Revised: 29 AUG 2010
  5. Manuscript Received: 21 MAY 2010

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Keywords:

  • multiple myeloma;
  • lenalidomide;
  • cytogenetics;
  • overall survival

Abstract

BACKGROUND:

In the era of novel agents such as lenalidomide and bortezomib, risk stratification by chromosomal abnormalities may enable a more rational selection of therapeutic approaches in patients with multiple myeloma (MM).

METHODS:

The authors analyzed the prognostic value of deletion del(13q14), del(17p13), +1q21, translocation t(4;14), t(11;14), and t(14;16) by fluorescence in situ hybridization (FISH) in a series of 92 patients with recurrent MM who were treated with lenalidomide and dexamethasone (len/dex) at the study center.

RESULTS:

Patients carrying del(13q14) or t(14;16) were found to have a shorter median time to disease progression (TTP) of 5.1 months (vs 14.4 months; P = .009) and 2.0 months (vs 10.5 months; P <.001), respectively. However, no effect on TTP was observed in patients harboring del(13q14) as an exclusive chromosomal aberration without the concomitant presence of t(4;14) or del(17p13). The median overall survival (OS) for patients with del(17p13) or +1q21 was 6.7 months (P = .002) and 8.3 months (P < .001), respectively, whereas the median OS for patients carrying none of these abnormalities was not reached. Multivariate analysis revealed that the effects of del(17p13) and +1q21 on OS were independent of patient age as well as the type and number of regimens administered before len/dex.

CONCLUSIONS:

The results of the current study suggest that the prognostic significance of t(4;14) may be ameliorated or eliminated in patients treated with len/dex, whereas the presence of del(17p13) or +1q21 is still associated with a dismal OS. The presence of t(11;14) and del(13q14) as exclusive chromosomal aberrations indicates no impact on outcome. Because of its rarity in MM, a confirmation of the prognostic role of the t(14;16) aberration is still pending. Cancer 2011. © 2010 American Cancer Society.

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