The Clinical Significance Of IgH Deletion In Multiple Myeloma

PartⅠ The clinical significance of IgH deletion in multiple myeloma【Objective】To explore the incidence,types,clinical characteristics,therapeutic efficacy,prognosis of IgH deletion in multiple myeloma.【Methods】239 patients with newly diagnosed multiple myeloma were incuded.To analyze the clinical characteristics and treatment.The survival prognosis of IgH deletion positive group and negative group were compared.【Results】The incidence of IgH deletion was 29.3%(70/239 cases).The most common types of IgH deletion were: 1G2R: 50.0%;1G1R: 21.4%;complex deletion: 17.1%.IgH rearrangement was positive in all patients with IgH deletion.The light chain type,ISS Ⅲand the high ratio of free light chain were more common in patients with IgH deletion.Patients with IgH deletion who treated with bortezomib-based chemotherapy and autologous hematopoietic stem cell transplantation,the effect reached more than PR could get better survive.Patients were divided into three groups according to IgH deletion group,IgH rearrangement without IgH deletion group and FISH total negative group.The overall response rate(ORR)of the three groups were 80 %,85 % and 97.4 %.The median OS was 35 months in the IgH deletion group,39 months in the IgH rearrangement group and74 months in the FISH total negative group.These results suggest that IgH deletion has poor prognosis.【Conclusions】1.IgH deletion is common in multiple myeloma.2.IgH rearrangement was positive in all patients with IgH deletion.3.Light-chain type,ISS Ⅲ and high ratio of free light chainwere common in IgH deletion group.4.ORR was low and the median OS was short in patients with IgH deletion,These results suggest that IgH deletion has poor prognosis.5.Patients with IgH deletion were given Bortezomib-based chemotherapy,≥ PR,autologous hematopoietic stem cell transplantation could obtain a better prognosis.PartⅡ The significances of conventional karyotype analysis、Fluorescence in situ hybridization(FISH)and Single nucleotide polymorphism(SNP) technology in multiple myeloma【Objective】To explore the incidence 、clinical characteristics of chromosomal abnormalities in multiple myeloma with conventional karyotyping technology,Fluorescence in situ hybridization(FISH)and Single nucleotide polymorphism(SNP).To anaylze the differeneces among the three techniques in patients with multiple myeloma.【Methods】43 cases with multiple myeloma were collected in the First Affiliated Hospital of Soochow University,and the incidence of each chromosomal abnormality in different methods were analyzed.【Results】32 patients were tested by three methods at the same time.The chromosomal abnormality rate of 32 patients was 96.9%.Among them,the detection rate of conventional karyotype was 25.0%,FISH was 75.0%,SNP was 84.4%.When the normal karyotypes were normal(24 cases),16 cases of abnormalities were detected by FISH and 19 cases were detected by SNP.When FISH was negative(8 cases),all the normal karyotypes were normal,SNP can detect an additional 6 cases of chromosomal abnormalities.when the SNP chip technology tips normal karyotype(5 cases),the conventional karyotype are normal karyotype,FISH technology can detect an additional 3 cases of abnormalities.It was found that the tumor load of patients with positive karyotype was higher than those with positive FISH and SNP.【Conclusions】1.In this study,96.9 % MM patients have cytogenetic abnormalities.2.The detection rate of conventional karyotypes in MM patients was 25.0 %,FISH was75.0 %,SNP was84.4 %.3.The tumor load of patients with positive karyotype was higher than those with FISH positive and SNP positive.4.Conventional karyotype analysis can identify the number and structural changes of all chromosomes;FISH can be used to detect changes with a specific probe in high sensitivity;SNP can accurately detect the copy number abnormality of the whole chromosome gene.The three detection methods are important for studying MM genetic abnormalities.