Dynamic cytogenetic evolution in multiple myeloma: prognostic implications from diagnosis to first relapse

Area of Science:

• Hematology
• Oncology
• Genetics

Background:

• Cytogenetic abnormalities (CAs) in multiple myeloma (MM) are typically assessed statically at diagnosis.
• Longitudinal monitoring reveals dynamic clonal evolution, especially during relapse.
• Data on CA dynamics and prognosis in Asian populations are limited.

Purpose of the Study:

• To investigate the dynamics of CAs in MM patients during relapse.
• To assess the prognostic impact of clonal burden, copy number alterations, and cytogenetic complexity evolution.
• To provide insights into CA dynamics in an Asian MM cohort.

Main Methods:

• Retrospective study of 106 MM patients (2014-2024).
• CAs evaluated at diagnosis and relapse using conventional চিত্র (cIg)-FISH.
• Prognostic impact of clonal burden, copy number alterations, and longitudinal evolution assessed.

Main Results:

• At first relapse, 33.0% of patients acquired new CAs, with increased 1q21+ and del(17p13).
• 1q21 amplification expanded significantly (27.4% to 40.6%), while gain remained stable.
• New CAs and clone expansion at relapse correlated with shorter progression-free survival and overall survival.

Conclusions:

• Acquisition of new CAs and expansion of existing clones at relapse are crucial prognostic indicators in MM.
• Dynamic monitoring of CAs during MM treatment is important for patient management.
• Findings highlight the prognostic significance of cytogenetic evolution in MM.