The novel translocation of t (1;21) in multiple myeloma with poor prognosis
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Objective: Multiple myeloma (MM) is characterized as the neoplastic proliferation of plasma cells producing a monoclonal paraprotein. The aim of this paper is to report complex karyotype that leads to a fatal clinical course in a patient with MM.
Case: A 48-year-old male patient was diagnosed as MM free lambda. The karyotype of the patient was 46, XY, t(1;21) (p11;p11), del(3) (q25;q29), del(6) (q24;q26), t(11;14) (q13;q32), del(13) (q14;q21) in cytogenetic evaluation. Vincristine, doxorubicin and dexamethasone were started. The creatinine levels increased after the second course of chemotherapy, the chemotherapy protocol was switched to bortezomib and dexamethasone. Patient was admitted to the emergency department with pneumonia after the second chemotherapy cycle. Despite using broad spectrum antibiotics and oxygen support, he died after the development of sepsis syndrome.
Conclusion: The anomaly of t (1;21) (p11;p11), that we detected in this case was detected in a case with MM for the first time and this anomaly has not been detected between these breaking points in any malignancies before. Although the prognostic impact of this unique anomaly may be unclear, further studies are needed to evaluate the effect of cytogenetic anomalies on prognosis of multiple myeloma.
2. Dias NEM. Acute myeloma kidney. Kidney international. 1995;48:1347-61.
3. Binder M, Rajkumar S, Ketterling R, Dispenzieri A, Lacy M, Gertz M, Buadi F, Hayman S, Hwa Y, Zeldenrust S. Occurrence and prognostic significance of cytogenetic evolution in patients with multiple myeloma. Blood cancer journal. 2016;6:3e401.
4. Amare PSK, Jain H, Nikalje S, Sengar M, Menon H, Inamdar N, Subramanian P, Gujral S, Shet T, Epari S. Observation on frequency & clinico-pathological significance of various cytogenetic risk groups in multiple myeloma: an experience from India. The Indian journal of medical research. 2016;144:4536.
5. Shin S-Y, Eom H-S, Sohn JY, Lee H, Park B, Joo J, Jang J-H, Lee M-N, Kim JK, Kong S-Y. Prognostic Implications of Monosomies in Patients With Multiple Myeloma. Clinical Lymphoma Myeloma and Leukemia. 2017;17:3159-64. e2.
6. Govindasamy P, Pandurangan P, Tarigopula A, Mani R, C RS. Cytogenetic Abnormalities in Multiple Myeloma Patients at a Tertiary Healthcare Center in India. Asian Pac J Cancer Prev. 2019;20:1235-41.10.31557/apjcp.2019.20.1.235.
7. Wang CB, Wu J, Yang K, Su M, Zhang HY, Pan YZ, Wu T, Xi R, Bai H. [Retrospective Analysis of Genetics Abnormalities in Patients with Multiple Myeloma]. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2018;26:61681-7.10.7534/j.issn.1009-2137.2018.06.017.
8. Shaffer LG, McGowan-Jordan J, Schmid M. ISCN 2013: an international system for human cytogenetic nomenclature (2013): Karger Medical and Scientific Publishers; 2013.
9. Sonneveld P, Avet-Loiseau H, Lonial S, Usmani S, Siegel D, Anderson KC, Chng WJ, Moreau P, Attal M, Kyle RA, Caers J, Hillengass J, San Miguel J, van de Donk NW, Einsele H, Blade J, Durie BG, Goldschmidt H, Mateos MV, Palumbo A, Orlowski R. Treatment of multiple myeloma with high-risk cytogenetics: a consensus of the International Myeloma Working Group. Blood. 2016;127:242955-62.10.1182/blood-2016-01-631200.
10. Li S, Lim HH, Woo KS, Kim SH, Han JY. A retrospective analysis of cytogenetic alterations in patients with newly diagnosed multiple myeloma: a single center study in Korea. Blood Res. 2016;51:2122-6.10.5045/br.2016.51.2.122.
11. Jekarl DW, Min C-K, Kwon A, Kim H, Chae H, Kim M, Lim J, Kim Y, Han K. Impact of genetic abnormalities on the prognoses and clinical parameters of patients with multiple myeloma. Annals of laboratory medicine. 2013;33:4248-54.
12. Sergentanis TN, Kastritis E, Terpos E, Dimopoulos MA, Psaltopoulou T. Cytogenetics and survival of multiple myeloma: Isolated and combined effects. Clinical Lymphoma Myeloma and Leukemia. 2016;16:6335-40.
13. Viguié F. del(13q) in multiple myeloma. Atlas Genet Cytogenet Oncol Haematol. 2001; 5(2):123-124.
14. Brigaudeau C. del(6q) in Multiple Myeloma. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):17-18.
15. Lawce H, Olson S. FISH testing for deletions of chromosome 6q21 and 6q23 in hematologic neoplastic disorders. J Assoc Genet Technol. 2009;35:4167-9.
16. Bozkurt S, Okay M, Haznedaroglu I. Aggressive Clinicopathological Course of Myeloma with t(3;16) (q21;q22) Cytogenetic Abnormality. Turk J Haematol. 2019;36:162-3.10.4274/tjh.galenos.2018.2018.0049.