Prognostic factors in MM and cytogenetic abnormalities and relationship with outcomes
| Prognostic factors . | |||
|---|---|---|---|
| Patient-related . | Disease burden-related . | Disease biology-related . | Therapy-related . |
| Age | High B2 microglobulin* | Cytogenetic abnormalities | Quality of response |
| Performance status | Low albumin* | GEP | Early relapse |
| Comorbidities | Renal impairment | Circulating PCs | |
| LDH above ULN | EMD | ||
| High proliferation rate | |||
| Cytogenetic abnormalities and relationship with outcomes | |||
| Chromosome/region (frequency) | Gene involved/effect | Prognostic implication | |
| 14q32 (locus IGH) (45-50%) | |||
| t(11;14) (20%) | Cyclin D1 hyperexpression | Neutral | |
| t(4;14) (10% to 15%) | FGFR3 and MMSET deregulated | Unfavorable (worsened by chromosome 1 alterations, improved by trisomy 5) | |
| t(14;16) (<5%) | cMAF | Doubt, mainly unfavorable | |
| t(14;20) (<5%) | UK | Doubt, mainly unfavorable | |
| 1q21 acquisition (30%) | CKS1B, MCL1 | ||
| Gain (2-3 copies) | Partially unfavorable | ||
| Amplification (≥4) | Unfavorable | ||
| 1p32 deletion (10%) | FAF1/ CDKN2C | Unfavorable | |
| 17p deletion (8% to 15% according to PC cutoff) | TP53 and UK | ||
| Single-hit | Deletion | Unfavorable | |
| Double-hit | Biallelic inactivation (deletion + mutation) | Very unfavorable | |
| Prognostic factors . | |||
|---|---|---|---|
| Patient-related . | Disease burden-related . | Disease biology-related . | Therapy-related . |
| Age | High B2 microglobulin* | Cytogenetic abnormalities | Quality of response |
| Performance status | Low albumin* | GEP | Early relapse |
| Comorbidities | Renal impairment | Circulating PCs | |
| LDH above ULN | EMD | ||
| High proliferation rate | |||
| Cytogenetic abnormalities and relationship with outcomes | |||
| Chromosome/region (frequency) | Gene involved/effect | Prognostic implication | |
| 14q32 (locus IGH) (45-50%) | |||
| t(11;14) (20%) | Cyclin D1 hyperexpression | Neutral | |
| t(4;14) (10% to 15%) | FGFR3 and MMSET deregulated | Unfavorable (worsened by chromosome 1 alterations, improved by trisomy 5) | |
| t(14;16) (<5%) | cMAF | Doubt, mainly unfavorable | |
| t(14;20) (<5%) | UK | Doubt, mainly unfavorable | |
| 1q21 acquisition (30%) | CKS1B, MCL1 | ||
| Gain (2-3 copies) | Partially unfavorable | ||
| Amplification (≥4) | Unfavorable | ||
| 1p32 deletion (10%) | FAF1/ CDKN2C | Unfavorable | |
| 17p deletion (8% to 15% according to PC cutoff) | TP53 and UK | ||
| Single-hit | Deletion | Unfavorable | |
| Double-hit | Biallelic inactivation (deletion + mutation) | Very unfavorable | |
UK, unknown; ULN, upper limit of normal.
ISS.