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Review Of High Risk Indicators In Multiple Myeloma Patients

Home/Review Of High Risk Indicators In Multiple Myeloma Patients

Review Of High Risk Indicators In Multiple Myeloma Patients

I don’t post a lot of study abstracts here anymore.  But this one caught my eye last month on OncologySTAT.  I saved it because I felt it provided a concise look at chromosomal issues which can be used to define a “high risk” multiple myeloma patient.  I have highlighted some key points:

Guidelines for Risk Stratification in Multiple Myeloma: Report of the International Myeloma Workshop Consensus Panel 2

Blood. 2011 Feb 3;[Epub Ahead of Print], NC Munshi, KC Anderson, PL Bergsagel, J Shaughnessy, A Palumbo, B Durie, R Fonseca, AK Stewart, J-L Harousseau, M Dimopoulos, S Jagannath, R Hajek, O Sezer, R Kyle, P Sonneveld, M Cavo, SV Rajkumar, J San Miguel, J Crowley, H Avet-Loiseau

Abstract
A panel of members of the 2009 International Myeloma Workshop developed guidelines for risk stratification in multiple myeloma (MM). The purpose of risk stratification is not to decide time of therapy but to prognosticate. There is general consensus that risk stratification is applicable to newly-diagnosed patients; however, same genetic abnormalities characteristic of poor outcome at diagnosis may suggest poor outcome if detected at the time of relapse. Thus in good risk patients it is necessary to evaluate for high-risk features at relapse. Although detection of any cytogenetic abnormality is considered to suggest higher risk disease, the specific abnormalities considered as poor risk are: cytogenetically detected Chromosomal 13 or 13q deletion, t(4;14) and del17p; and detection by FISH of t(4;14); t(14;16) and del17p. Detection of 13q deletion by FISH only, in absence of other abnormalities, is not considered a high-risk feature. High serum β2M level and ISS stage II and III incorporating high β2-M and low albumin are considered to predict higher risk disease. There was a consensus that the high risk features will change in the future, with introduction of other new agents or possibly new combinations.

Bottom line:  Consider having your oncologist/hematologist re-run genetic testing after first relapse, because the genetic make-up of myeloma can change after treatment.

Feel good and keep smiling!  Pat