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Bei Wang1, Benjamin A Derman2, Madina Sukhanova3

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Cytogenetic abnormalities impact multiple myeloma (MM) survival differently in European Americans (EAs) and African Americans (AAs). High-risk abnormalities affect EA survival, while specific ones like del 13q impact both groups, but t(4;14) uniquely affects AA survival.

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Area of Science:

  • Hematology
  • Genetics
  • Oncology

Background:

  • Cytogenetic abnormalities are crucial prognostic factors in multiple myeloma (MM).
  • Understanding survival differences associated with these abnormalities in diverse populations, specifically European Americans (EAs) and African Americans (AAs), is vital.
  • Existing research has not fully elucidated these population-specific associations.

Purpose of the Study:

  • To investigate the association between specific cytogenetic abnormalities and overall survival (OS) in newly diagnosed MM patients from EA and AA populations.
  • To identify potential population-specific prognostic significance of cytogenetic abnormalities in MM.

Main Methods:

  • Retrospective analysis of fluorescence in situ hybridization (FISH) data for 17 cytogenetic abnormalities in 181 newly diagnosed MM patients (55 AAs, 126 EAs) between 2010-2019.
  • Vital status ascertained via the National Death Index; clinical data from electronic medical records.
  • Statistical evaluation of associations between cytogenetic abnormalities and OS, controlling for prognostic factors and other high-risk cytogenetic abnormalities (HRCAs).

Main Results:

  • The distribution of cytogenetic abnormalities was similar between EA and AA populations.
  • High-risk MM (defined by HRCAs) was linked to worse OS in EAs (HR 2.6) but not AAs.
  • Del 13q was associated with worse OS in both populations. Gain/amplification of 1q worsened OS in EAs (HR 3.44), while t(4;14) significantly worsened OS in AAs (HR 14.51).

Conclusions:

  • Cytogenetic abnormalities have differential prognostic significance for overall survival in multiple myeloma patients based on race.
  • Gain/amplification of 1q and HRCAs portend poorer survival in EAs, whereas t(4;14) is a particularly poor prognostic marker in AAs.
  • These findings underscore the importance of considering population heterogeneity in the prognostic evaluation and management of multiple myeloma.