Abnormal FISH in patients with immunoglobulin light chain amyloidosis is a risk factor for cardiac involvement and for death
Open Access
- 1 May 2015
- journal article
- research article
- Published by Springer Science and Business Media LLC in Blood Cancer Journal
- Vol. 5 (5), e310
- https://doi.org/10.1038/bcj.2015.34
Abstract
Importance of interphase fluorescent in situ hybridization (FISH) with cytoplasmic staining of immunoglobulin FISH (cIg-FISH) on bone marrow is not well understood in light chain amyloidosis (AL). This is in contrast with multiple myeloma where prognostic and treatment related decisions are dependent on cytogenetic testing. This retrospective study reviewed 401 AL patients with cIg-FISH testing performed at our institution between 2004 and 2012. Eighty-one percent of patients had an abnormal cIg-FISH. Common abnormalities involved translocations of chromosome 14q32 (52%), specifically: t(11;14) (43%), t(14;16) (3%) and t(4;14) (2%). Other common abnormalities include monosomy 13/deletion 13q (30%), trisomies 9 (20%), 15 (14%), 11 (10%) and 3 (10%). Median overall survival for this cohort of patients is 3.5 years. When plasma cell burden was greater than 10% trisomies predicted for worse survival (44 vs 19 months), and when it was ⩽10% t(11;14) predicted for worse survival (53 months vs not reached). Abnormal cIg-FISH was significantly associated with advanced cardiac involvement, and remained a prognostic factor on multivariate analysis. This large AL cohort demonstrates that abnormal FISH at diagnosis is prognostic for survival and advanced cardiac disease. Particularly, trisomies and t(11;14) affect survival when degree of plasma cell burden is considered.Keywords
This publication has 17 references indexed in Scilit:
- Gain of chromosome 1q21 is an independent adverse prognostic factor in light chain amyloidosis patients treated with melphalan/dexamethasoneAmyloid, 2013
- Management of Newly Diagnosed Symptomatic Multiple Myeloma: Updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) Consensus Guidelines 2013Mayo Clinic Proceedings, 2013
- Impact of primary molecular cytogenetic abnormalities and risk of progression in smoldering multiple myelomaLeukemia, 2013
- Serum Cardiac Troponins and N-Terminal Pro-Brain Natriuretic Peptide: A Staging System for Primary Systemic AmyloidosisJournal of Clinical Oncology, 2004
- Genetics and Cytogenetics of Multiple MyelomaCancer Research, 2004
- The recurrent IgH translocations are highly associated with nonhyperdiploid variant multiple myelomaBlood, 2003
- Translocations of 14q32 and deletions of 13q14 are common chromosomal abnormalities in systemic amyloidosisBritish Journal of Haematology, 2002
- Translocations involving the immunoglobulin heavy-chain locus are possible early genetic events in patients with primary systemic amyloidosisBlood, 2001
- Eligibility for Hematopoietic Stem-Cell Transplantation for Primary Systemic Amyloidosis Is a Favorable Prognostic Factor for SurvivalJournal of Clinical Oncology, 2001
- Translocation t(4;14)(p16.3;q32) Is a Recurrent Genetic Lesion in Primary AmyloidosisThe American Journal of Pathology, 2001