IgH translocations are common -if not initiating events- of most plasma cell dyscrasias. The translocation t(ll;14)(ql3;q32) is the most common IgH translocation detected in MM and has been previously thought to be associated with an adverse outcome. To better understand the biologic and prognostic significance of the t(l 1;14) we studied 340 MM patients entered into the ECOG clinical trial E9487 for this abnormality. Frozen cytospin slides obtained at the time of study entry were used to perform interphase FISH for the detection of the t(ll;14) with simultaneous immunofluorescent detection of the cytoplasmic light chain (clg-FISH). Paraffin embedded bone marrow biopsies were available in 62 patients for immunohistochemical analysis of cyclin Dl nuclear staining (overexpression). A total of 336 patients could be analyzed for the t(l 1;14) (failure rate 4%). Of these 53 showed evidence of a t(l 1;14) (16%). Of 62 patients tested for cyclin Dl staining 5 were positive (8%). All patients with a cyclin Dl positive staining also had the t(ll;14) detected by FISH, but not all cases of t(ll;14) were associated with cyclin DI positive staining (p<0.001). The clinical features of patients were compared between patients with and without the abnormality. Patients with the t(11 ;14) were more frequently associated with the absence of a serum M component (Chi-square p=0.02). Plasmacytomas appeared to be less common in patients with the t(ll;14) (p=0.2). Younger patients (age 40 and younger) had a particularly high prevalence of the t(ll;14) (43 vs 15%, p=0.04). Patients with the t(l 1;14) appeared to be more likely to have an objective response to treatment (79 vs 67%, p=NS). A Kaplan-Meier analysis suggested that patients with the t(l 1;14) had better overall survival (median survival, 49.6 versus 38.7 months, p0.2) and progression free survival (33 vs 28 months, p0.2) but both were not statistically significant. There were no perceived differences in the number of long term survivors between patients with or without t(ll;14) (7.5 vs 8.8%). Additional work is needed to better characterize the biologic features of MM patients with the t(ll;14)(ql3;q32).
|Original language||English (US)|
|Issue number||11 PART I|
|State||Published - Dec 1 2000|