MM-375: Prognostic Impact of Multiple Myeloma Cytogenetic Abnormalities on Outcome of Autologous Bone Marrow Transplantation: A Single-Center Experience

Abstract

Context: Multiple myeloma (MM) is a malignant plasma cell disorder with heterogeneous outcomes because of genetic abnormalities. Thus, risk stratification-based treatment selection is a target of most clinical trials. Objective: This study aimed to identify the prognostic impact of cytogenetic aberrations, including t(4;14), del(17p), del(13q), and t(11;14) on outcome of MM. Design: This study analyzed a total of 25 newly diagnosed Egyptian MM patients with available iFISH results for t(4;14), del(17p), del (13q), and t(11;14) during a period of 5 years. Setting: The patients received chemotherapy at El Sheikh Zayed Hospital and then proceeded to autologous stem cell transplantation. Patients: All patients received a median of five cycles of induction therapy by VCD before stem cell collection, and then patients proceeded to HSCT. Main outcome measures: The median OS of the whole group was 75.77 months, and the median PFS was 49.87 months. Results: Mean age of patients at transplantation was 54.4 ± 7.04 years. Patients with del(17p) had higher % of plasma cells in bone marrow and presented with significantly lower hemoglobin levels than non-del(17p). Also, 60% of t(4;14) cases were IgA kappa vs 15% in non-t(4;14). These findings suggests the worse prognosis of t(4;14) and del (17p). Median PFS in t(4;14) vs non-t(4;14) was 36 vs 88.5 months (p=0.001) and median OS in t(4;14) vs non t(4;14) was 36.625 vs 85.014 months (p=0.005). Median PFS in del(17p) vs non-del (17p) was 23.3 vs 52.937 months (p=0.014) and median OS in del (17p) vs non-del(17p) was 35.5 vs 81.029 months (p=0.008). Median PFS in t(11;14) vs non t(11;14) was 49.12 vs 41.06 months (p=0.39), and median OS in t(11;14) vs non-t(11;14) was 93 vs 48.146 months (p=0.38). Median PFS in del(13q) vs non-del(13q) was 20.667 vs 50.955 months (p=0.282), and median OS in del (13q) vs non-del(13q) was 35 vs 77.771 months (p=0.208). Conclusions: The t(4;14) and del(17p) are high-risk abnormalities associated with dismal outcome. Both bortezomib-based regimen and ASCT can improve but not overcome the dismal outcome of these abnormalities.