Clinical impact of chromosomal aberrations in multiple myeloma

Authors


Gösta Gahrton, Department of Medicine, M54 Karolinska University, Hospital Huddinge, 141 86 Stockholm, Sweden.
(fax: 46-8-7748725; e-mail: Gosta.Gahrton@ki.se).

Abstract

Abstract.  Nahi H., Sutlu T., Jansson M., Alici E., Gahrton G. (Karolinska Institutet, Karolinska University Hospital Huddinge; Hematology Centre, Karolinska University Hospital, Huddinge, Stockholm, Sweden) Clinical impact of chromosomal aberrations in multiple myeloma (Review). J Intern Med 2011; 269: 137–147.

Chromosomal aberrations are frequently found in multiple myeloma cells and play a major role in patient outcome and management of the disease. The most important chromosomal aberrations associated with poor outcome are del(17p), t(4;14), t(14;16) and t(14;20). Others that may be associated with adverse prognosis include amp(1)(q21), del(1p32), del(13), del(8p21) and hypodiploidy. Many chromosomal aberrations have no or uncertain impact; for example, t(11;14), t(8;14) and hyperdiploidy. Attempts have been made to overcome the negative prognostic impact of chromosomal aberrations using autologous or allogeneic transplantation or new immunomodulatory drugs such as thalidomide, lenalidomide and the proteasome inhibitor bortezomib, but the results are controversial. Data suggest that allogeneic transplantation and treatment with bortezomib or lenalidomide may help to overcome the negative effect of del(13) on prognosis, whereas bortezomib may have some influence on reducing the impact of del(17p), t(4;14) and t(14;16). Chromosome analysis should always be performed at diagnosis of multiple myeloma to improve the prediction of outcome and to aid treatment decision-making.

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