The t(14;20) is a poor prognostic factor in myeloma but is associated with long term stable disease in MGUS

Ross, Fiona M., Chiecchio, Laura, Dagrada, GianPaolo, Protheroe, Rebecca K.M., Stockley, David M., Harrison, Christine J., Cross, Nicholas C.P., Szubert, Alex J., Drayson, Mark T. and Morgan, Gareth J. (2010) The t(14;20) is a poor prognostic factor in myeloma but is associated with long term stable disease in MGUS. Haematologica, 95 (7), 1221-1225. (doi:10.3324/haematol.2009.016329).

Abstract

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 behaviour was compared to a group characterised 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%), nonhyperdiploidy (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/smouldering 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.

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Contributors

Author: Nicholas C.P. Cross

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