Prognostic Significancean Overview

Even early CC studies demonstrated the adverse prognostic significance of abnormal karyotypes in myeloma.65 Patients with abnormal karyotypes are more likely to have features of aggressive disease: lower hemoglobin, higher ^-microglobulin, higher labeling index, and higher percentage of plasma cells in the marrow (P < .0001)66 and, in long-term follow-up, patients with the best outcome are those with no evidence of cytogenetic abnormalities at either diagnosis or relapse.31

By CC, the most consistent chromosomal abnormality associated with poor prognosis is del(13q), including both complete and partial deletions.2527 This finding has since been confirmed in most molecular cytogenetics series.23'29'31'33 Conventional karyotyping has also demonstrated the poor prognostic significance associated with chromosome 11q translocations, including t(11;14) translocation and reciprocal translocations with chromosomes 8, 9, and 12.25 42 However, this was not confirmed by molecular cytogenetics.40 The combination of aberrations of both chromosomes 11 and 13 results in a dismal outcome.25

The hyperdiploid group, comprising 30-40%, is usually considered to carry a favorable prognosis, whereas hypodiploidy is associated with a poor prognosis.

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