Affiliations 

  • 1 Universiti Sains Malaysia (USM), Kubang Kerian, Kelantan
  • 2 Hospital Tunku Azizah, 50300 Kuala Lumpur
MyJurnal

Abstract

Introduction: Multiple myeloma (MM) is characterized by genomic instability and cytogenetic abnormalities (CAs). The variation in rates of treatment response and overall survival is thought to arise from multiple genomic events that result in tumour development and progression. This study investigated CAs among the newly diagnosed MM (NDMM) patients at diagnosis and during follow-up and subsequently to assess their prognostic significance. Meth- ods: This is a prospective cohort study where bone marrow (BM) samples of 16 NDMM patients were collected at diagnosis and during follow up and subjected to conventional cytogenetic analysis (CCA) and interphase fluores- cence in situ hybridization (iFISH) analyses using standard procedures. Spectral karyotyping was performed on a selected patient who showed complex karyotype (CK) pattern on CCA. Results: Clonal abnormalities were identified in 56.3% of analysis by karyotyping and 68.8% by combination of karyotyping and iFISH. CCA showed normal diploid, hypodiploid and hyperdiploid karyotypes, whereas iFISH analysis could detect various IGH translocations involving 14q32 region, del(13q14) and del(17p13). Significant associations were observed between patients with complex karyotypes and abnormal karyotypes. Patients who had a CK or showed an abnormal CCA and iFISH results were associated with worse survival (p=0.011 and p=0.034 respectively). Structural abnormalities were found to be more common among hyperdiploid MM patients (p=0.001). Cytogenetic evolution was seen in the follow-up of BM cytogenetics. Conclusion: Karyotyping and iFISH are valuable assets in detecting prognostically relevant genomic abnormalities. The presence of cytogenetic evolution demonstrated the value of cytogenetics in monitoring treatment response and in management of MM.