Open AccessAL amyloidosis: The effect of fluorescent in situ hybridization abnormalities on organ involvement and survival
Author(s) -
Ozga Michael,
Zhao Qiuhong,
Benson Don,
Elder Patrick,
Williams Nita,
Bumma Naresh,
Rosko Ashley,
Chaudhry Maria,
Khan Abdullah,
Devarakonda Srinivas,
Kahwash Rami,
Vallakati Ajay,
Campbell Courtney,
Parikh Samir V.,
Almaani Salem,
Prosek Jason,
Bittengle Jordan,
Pfund Katherine,
LoRusso Samantha,
Freimer Miriam,
Redder Elyse,
Efebera Yvonne,
Sharma Nidhi
Publication year - 2021
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.3683
Subject(s) - medicine , fluorescence in situ hybridization , hazard ratio , proportional hazards model , al amyloidosis , survival analysis , multiple myeloma , oncology , progression free survival , amyloidosis , log rank test , gastroenterology , pathology , biology , overall survival , confidence interval , immunology , immunoglobulin light chain , chromosome , genetics , antibody , gene
Background Systemic light chain (AL) amyloidosis is a clonal plasma‐cell neoplasm that carries a poor prognosis. Although AL amyloidosis and Multiple Myeloma (MM) can co‐exist and share various cytogenetic chromosomal abnormalities, little is known about Fluorescent in situ hybridization (FISH) and its prognostic relevance in AL amyloidosis. Aim: The study aims to evaluate the most prevalent FISH cytogenetic abnormalities in AL patients as independent prognostic factors, and assess the impact of cytogenetics on the survival of high‐risk cardiac AL patients. Materials & Methods This retrospective study reviewed 113 consecutive AL patients treated at The Ohio State University (OSU). Patients were divided into subgroups based on FISH data obtained within 90 days of diagnosis. Hyperdiploidy was defined as trisomies of at least 2 chromosomal loci. Primary endpoints were progression free survival (PFS) and overall survival (OS). Kaplan Meier curves were used to calculate PFS and OS. The log‐rank test and Cox proportional hazard models were used to test the equality of survival functions and further evaluate the differences between groups. Results FISH abnormalities were detected in 76% of patients. Patients with abnormal FISH trended toward lower overall survival (OS) (p=0.06) and progression free survival (PFS) (p=0.06). The two most prevalent aberrations were translocation t(11;14) (39%) and hyperdiploidy‐overall (38%). Hyperdiploidy‐overall was associated with worsening PFS (p=0.018) and OS (p=0.03), confirmed in multivariable analysis. Patients with del 13q most frequently had cardiac involvement (p=0.006) and was associated with increased bone marrow plasmacytosis (p=0.02). Cardiac AL patients with no FISH abnormalities had much improved OS (p=0.012) and PFS (p=0.018) Conclusions Our findings ultimately reveal the association of hyperdiploidy on survival in AL amyloidosis patients, including the high‐risk cardiac AL population.