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Prepublished online as a Blood First Edition Paper on May 17, 2002; DOI 10.1182/blood-2002-03-0749.
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Blood, 1 September 2002, Vol. 100, No. 5, pp. 1579-1583
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Recurrent 14q32 translocations determine the prognosis of
multiple myeloma, especially in patients receiving intensive
chemotherapy
Philippe Moreau,
Thierry Facon,
Xavier Leleu,
Nadine Morineau,
Pauline Huyghe,
Jean-Luc Harousseau,
Régis Bataille, and
Hervé Avet-Loiseau for the Intergroupe Francophone
du Myélome
From the Clinical Hematology Department and the
Hematology Laboratory, University Hospital, Nantes, France; and the
Clinical Hematology Department, University Hospital, Lille, France.
Recently, we have described the biological correlations associated
with the main translocations involving the 14q32 chromosomal region,
that is, t(14q32), in patients with multiple myeloma (MM). We have now
extended the analysis to the prognostic value of these chromosomal
rearrangements in 168 consecutive patients with newly diagnosed
MM receiving intensive chemotherapy within clinical trials of the Intergroupe Francophone du Myelome (IFM).
Patients with t(4;14) displayed a poor outcome (short event-free
survival and short overall survival), whereas those
with t(11;14) displayed long survival. On the other hand, patients with
neither t(4;14) nor t(11;14) presented an intermediate outcome.
Importantly, chromosome 13 abnormalities (C13As) significantly
influence the prognosis of this latter group. In contrast,
C13As affected the outcome of the other patients to a much lesser
extent, either because of an almost constant association (in
the t(4;14) group) or because of a lack of any
significant prognostic impact (in the t(11;14) group; only
one event occurred in the 10 patients with t(11;14) and C13As).
Considering that t(4;14) and t(11;14) (1) are the only (so far
recognized) true, recurrent t(14q32)'s, (2) are linked to specific
immunoglobulin isotypes, and (3) display specific outcomes, they represent distinct entities corresponding to a specific
oncogenesis and prognosis. These data emphasized the interest in
analyzing these two translocations by fluorescence in situ
hybridization in prospective therapeutic trials in order to consider
these translocations as distinct entities.
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