RESEARCH HIGHLIGHTS Nature Reviews Clinical Oncology 10, 671 (2013); published online 12 November 2013; doi:10.1038/nrclinonc.2013.214
HAEMATOLOGICAL CANCER
Abnormal chromosomes forecast rapid disease progression in SMM
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Smouldering multiple myeloma (SMM) is an asymptomatic disorder of plasma cells that has a high risk of progression to symptomatic (active) myeloma. From the analysis of samples from 248 patients with SMM, Kai Neben and colleagues now report that genetic aberrations such as deletion of the short arm of chromosome 17 (del17p), chromosomal translocation t(4;14), gain of the long arm of chromosome 1 (+1q21), and hyperdiploidy are adverse prognostic factors. Patients with any of these aberrations experience rapid progression from the time of SMM diagnosis to the point when they receive treatment. Interestingly, although del17p, t(4;14) and +1q21 are also predictors of poor prognosis in symptomatic myeloma, this is not the case for hyperdiploidy, which becomes a favourable prognostic factor in active myeloma.
The researchers confirm that although tumour load significantly affects disease progression, tumour mass and chromosome alterations are independent prognostic factors. In addition, they show that the proportion of malignant plasma cells is highly predictive of time to progression. These results underline the importance of a genetic assessment of all patients with SMM, as the presence of specific chromosomal aberrations might help clinicians identify those patients who are at highest risk of rapid progression to active myeloma. Alessia Errico Original article Neben, K. et al. Progression in smoldering myeloma is independently determined by the chromosomal abnormalities del(17p), t(4;14), gain 1q, hyperdiploidy, and tumor load. J. Cin. Oncol. doi:10.1200/JCO.2012.48.4923
NATURE REVIEWS | CLINICAL ONCOLOGY
VOLUME 10 | DECEMBER 2013 © 2013 Macmillan Publishers Limited. All rights reserved
HAEMATOLOGICAL CANCER
Abnormal chromosomes forecast rapid disease progression in SMM
NP
G
Smouldering multiple myeloma (SMM) is an asymptomatic disorder of plasma cells that has a high risk of progression to symptomatic (active) myeloma. From the analysis of samples from 248 patients with SMM, Kai Neben and colleagues now report that genetic aberrations such as deletion of the short arm of chromosome 17 (del17p), chromosomal translocation t(4;14), gain of the long arm of chromosome 1 (+1q21), and hyperdiploidy are adverse prognostic factors. Patients with any of these aberrations experience rapid progression from the time of SMM diagnosis to the point when they receive treatment. Interestingly, although del17p, t(4;14) and +1q21 are also predictors of poor prognosis in symptomatic myeloma, this is not the case for hyperdiploidy, which becomes a favourable prognostic factor in active myeloma.
The researchers confirm that although tumour load significantly affects disease progression, tumour mass and chromosome alterations are independent prognostic factors. In addition, they show that the proportion of malignant plasma cells is highly predictive of time to progression. These results underline the importance of a genetic assessment of all patients with SMM, as the presence of specific chromosomal aberrations might help clinicians identify those patients who are at highest risk of rapid progression to active myeloma. Alessia Errico Original article Neben, K. et al. Progression in smoldering myeloma is independently determined by the chromosomal abnormalities del(17p), t(4;14), gain 1q, hyperdiploidy, and tumor load. J. Cin. Oncol. doi:10.1200/JCO.2012.48.4923
NATURE REVIEWS | CLINICAL ONCOLOGY
VOLUME 10 | DECEMBER 2013 © 2013 Macmillan Publishers Limited. All rights reserved
