Open AccessThe t(14;20) is a poor prognostic factor in myeloma but is associated with long-term stable disease in monoclonal gammopathies of undetermined significance
Author(s) -
Fiona Ross,
Laura Chiecchio,
Gian Paolo Dagrada,
Rebecca K.M. Protheroe,
David Stockley,
Christine J. Harrison,
Nicholas C. P. Cross,
Alex J. Szubert,
Mark T. Drayson,
Gareth J. Morgan
Publication year - 2010
Publication title -
haematologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.782
H-Index - 142
eISSN - 1592-8721
pISSN - 0390-6078
DOI - 10.3324/haematol.2009.016329
Subject(s) - multiple myeloma , monoclonal gammopathy of undetermined significance , medicine , chromosomal translocation , plasma cell , incidence (geometry) , oncology , immunopathology , immunology , monoclonal , gastroenterology , biology , antibody , monoclonal antibody , genetics , gene , physics , optics
A large series of plasma cell dyscrasias (n=2207) was examined for translocations which deregulate the MAF genes, t(14;20)(q32;q12) and t(14;16)(q32;q23), and their disease behavior was compared to a group characterized by the t(4;14)(p16;q32) where CCND2 is also up-regulated. The t(14;20) showed low prevalence in myeloma (27/1830, 1.5%) and smoldering myeloma (1/148, <1%) with a higher incidence in MGUS (9/193, 5% P=0.005). Strong associations with del(13) (76%), non-hyperdiploidy (83%) and gain of 1q (58%) were seen but no association with an IgA M-protein or absence of bone disease was noted. All three translocations were associated with poor outcome in myeloma, but strikingly all t(14;20) MGUS/smoldering myeloma cases (n=10) had stable, low level disease. In contrast, the 10 t(14;16) and 25 t(4;14) MGUS/smoldering myeloma cases were associated with both evolving and non-evolving disease. None of the associated genetic abnormalities helped to predict for progression from MGUS or smoldering myeloma.