Gene-Expression Profiling in Newly Diagnosed Multiple Myeloma
A team from The University of Texas MD Anderson Cancer Center in Houston has found that gene-expression profiling appears to be superior to standard fluorescent in situ hybridization (FISH) in predicting relapse-free survival in patients with newly diagnosed multiple myeloma.
“Uniformly, patients with high-risk FISH abnormalities and low-risk gene-expression profiling had better clinical outcomes than patients with high-risk gene-expression profiling,” wrote co-lead author Catherine M. Claussen, MS, and colleagues in the abstract presented at the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 4365).
Over almost 3 years ending in January 2017, the team identified 104 patients at MD Anderson from whom purified CD138-positive bone marrow plasma cells had been drawn for gene-expression profiling at diagnosis. All patients were treated with at least a three-drug combination, and 73% received an upfront autologous stem cell transplant.
Twenty percent of the cohort was considered high-risk with gene-expression profiling. The gene-expression profiling risk category significantly predicted relapse-free survival (P=.0005): Although 50% of the high-risk patients had relapsed or died at 1 year, 5% of patients in all other gene-expression profiling categories had died at 1 year. Utilizing FISH, t(14;16) alone predicted relapse-free survival (P=.0001).
At up to 36 months’ follow-up, overall survival was not yet significantly predicted by gene-expression profiling or FISH (P >.05). “Longer follow-up will be needed to determine prediction of overall survival in this cohort of patients,” concluded the team.