PMID- 11238092
OWN - NLM
STAT- MEDLINE
DCOM- 20010426
LR  - 20210216
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 97
IP  - 6
DP  - 2001 Mar 15
TI  - Chromosome 13 abnormalities identified by FISH analysis and serum 
      beta2-microglobulin produce a powerful myeloma staging system for patients 
      receiving high-dose therapy.
PG  - 1566-71
AB  - A careful prognostic evaluation of patients referred for high-dose therapy (HDT) 
      is warranted to identify those who maximally benefit from HDT as well as those 
      who clearly fail current HDT and are candidates for more innovative treatments. 
      In a series of 110 patients with myeloma who received HDT as first-line therapy, 
      times to event (disease progression and death) were studied through proportional 
      hazard models, in relation to different prognostic factors, including a 
      chromosome 13 fluorescence in situ hybridization (FISH) analysis using a D13S319 
      probe. Delta13 was detected in 42 patients (38%). Follow-up time among surviving 
      patients and survival time were 48 +/- 3 and 51 +/- 7 months, respectively 
      (median +/- SE). In the univariate analysis, Delta13 was the most powerful 
      adverse prognostic factor for all times to event, especially for the survival 
      time (P <.0001) and was followed by beta2-microglobulin (beta2m) levels 2.5 mg/L 
      or higher (P =.0001). The comparison of survival prognostic models including 
      beta2m 2.5 mg/L or greater and another factor favored the Delta13/beta2m 
      combination. In 22 patients (20%) with no unfavorable factor, the median survival 
      time was not reached at 111 months. In contrast, among 55 patients (50%) with one 
      unfavorable factor and 33 patients (30%) with 2 unfavorable factors, median 
      survival times were 47.3 +/- 4.6 months and 25.3 +/- 3.2 months, respectively (P 
      <.0001). We conclude that delta13, adequately detected by FISH analysis, is a 
      very strong factor related to poor survival, especially when associated with a 
      beta2m level of 2.5 mg/L or higher. Routine FISH Delta13 assessment is strongly 
      recommended for patients considered for HDT.
FAU - Facon, T
AU  - Facon T
AD  - Service d'Hematologie and Laboratoire de Genetique Medicale, Lille, France. 
      t-facon@chru-lille.fr
FAU - Avet-Loiseau, H
AU  - Avet-Loiseau H
FAU - Guillerm, G
AU  - Guillerm G
FAU - Moreau, P
AU  - Moreau P
FAU - Genevieve, F
AU  - Genevieve F
FAU - Zandecki, M
AU  - Zandecki M
FAU - Lai, J L
AU  - Lai JL
FAU - Leleu, X
AU  - Leleu X
FAU - Jouet, J P
AU  - Jouet JP
FAU - Bauters, F
AU  - Bauters F
FAU - Harousseau, J L
AU  - Harousseau JL
FAU - Bataille, R
AU  - Bataille R
FAU - Mary, J Y
AU  - Mary JY
CN  - Intergroupe Francophone du Myelome
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (beta 2-Microglobulin)
SB  - IM
MH  - Actuarial Analysis
MH  - Adult
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/administration & 
      dosage/therapeutic use
MH  - Chromosome Aberrations/*genetics
MH  - Chromosome Disorders
MH  - Chromosomes, Human, Pair 13/*genetics
MH  - Dose-Response Relationship, Drug
MH  - Drug Monitoring/methods
MH  - Follow-Up Studies
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Middle Aged
MH  - Multiple Myeloma/blood/*genetics/*pathology
MH  - Neoplasm Staging/*methods
MH  - Prognosis
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - beta 2-Microglobulin/*blood
EDAT- 2001/03/10 10:00
MHDA- 2001/05/01 10:01
CRDT- 2001/03/10 10:00
PHST- 2001/03/10 10:00 [pubmed]
PHST- 2001/05/01 10:01 [medline]
PHST- 2001/03/10 10:00 [entrez]
AID - S0006-4971(20)56169-7 [pii]
AID - 10.1182/blood.v97.6.1566 [doi]
PST - ppublish
SO  - Blood. 2001 Mar 15;97(6):1566-71. doi: 10.1182/blood.v97.6.1566.