PMID- 20721886
OWN - NLM
STAT- MEDLINE
DCOM- 20101012
LR  - 20151119
IS  - 1096-8652 (Electronic)
IS  - 0361-8609 (Linking)
VI  - 85
IP  - 10
DP  - 2010 Oct
TI  - An abnormal nonhyperdiploid karyotype is a significant adverse prognostic factor 
      for multiple myeloma in the bortezomib era.
PG  - 752-6
LID - 10.1002/ajh.21812 [doi]
AB  - Multiple myeloma is clinically heterogeneous and risk stratification is vital for 
      prognostication and informing treatment decisions. As bortezomib is able to 
      overcome several high-risk features of myeloma, the validity of conventional 
      risk-stratification and prognostication systems needs to be reevaluated. We study 
      the survival data of 261 previously untreated myeloma patients managed at our 
      institution, where bortezomib became available from 2004 for the treatment of 
      relapse disease. Patient and disease characteristics, and survival data were 
      evaluated overall, and with respect to bortezomib exposure. Overall, the 
      international staging system (ISS), metaphase karyotyping and interphase 
      fluorescence in situ hybridization (FISH) were discerning of survival outcomes, 
      where the median for the entire cohort was 5.2 years. However, when stratified by 
      bortezomib exposure, only metaphase karyotyping was still discriminating of 
      long-term prognosis. The presence of an abnormal nonhyperdiploid karyotype 
      overrides all other clinical and laboratory parameters in predicting for a worse 
      outcome on multivariate analysis (median survival 2.6 years, P = 0.001), 
      suggesting that bortezomib used at relapse is better able to overcome adverse 
      risk related to high tumor burden (as measured by the ISS) than adverse 
      cytogenetics on conventional karyotyping. Metaphase karyotyping provides 
      additional prognostic information on tumor kinetics where the presence of a 
      normal diploid karyotype in the absence of any high-risk FISH markers correlated 
      with superior survival and could act as a surrogate for lower plasma cell 
      proliferation.
CI  - (c) 2010 Wiley-Liss, Inc.
FAU - Tan, Daryl
AU  - Tan D
AD  - Department of Hematology, Singapore General Hospital, Outram Road, Singapore, 
      Republic of Singapore. daryl.tan@sgh.com.sg
FAU - Teoh, Gerrard
AU  - Teoh G
FAU - Lau, L C
AU  - Lau LC
FAU - Lim, Alvin
AU  - Lim A
FAU - Lim, T H
AU  - Lim TH
FAU - Yap, K C
AU  - Yap KC
FAU - Premalatha, P
AU  - Premalatha P
FAU - Lao, Z T
AU  - Lao ZT
FAU - Wee, Nelson
AU  - Wee N
FAU - Choo, Christine
AU  - Choo C
FAU - Wee, H C
AU  - Wee HC
FAU - Su, S
AU  - Su S
FAU - Lee, Y S
AU  - Lee YS
FAU - Lee, L H
AU  - Lee LH
FAU - Hwang, William
AU  - Hwang W
FAU - Goh, Y T
AU  - Goh YT
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Hematol
JT  - American journal of hematology
JID - 7610369
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Boronic Acids)
RN  - 0 (Pyrazines)
RN  - 69G8BD63PP (Bortezomib)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Aneuploidy
MH  - Antineoplastic Agents/*therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Bone Marrow/pathology
MH  - Boronic Acids/*therapeutic use
MH  - Bortezomib
MH  - Cohort Studies
MH  - Combined Modality Therapy
MH  - Female
MH  - Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Kaplan-Meier Estimate
MH  - Karyotyping/*methods
MH  - Male
MH  - *Metaphase
MH  - Middle Aged
MH  - Multiple Myeloma/drug therapy/*genetics/mortality
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Pyrazines/*therapeutic use
MH  - Retrospective Studies
MH  - Salvage Therapy
MH  - Translocation, Genetic
MH  - Transplantation, Autologous
MH  - Treatment Outcome
EDAT- 2010/08/20 06:00
MHDA- 2010/10/13 06:00
CRDT- 2010/08/20 06:00
PHST- 2010/08/20 06:00 [entrez]
PHST- 2010/08/20 06:00 [pubmed]
PHST- 2010/10/13 06:00 [medline]
AID - 10.1002/ajh.21812 [doi]
PST - ppublish
SO  - Am J Hematol. 2010 Oct;85(10):752-6. doi: 10.1002/ajh.21812.