Predictive value and prognostic importance of cytogenetic anomalies in treatment in multiple myeloma

ABSTRACT INTRODUCTION AND OBJECTIVE: Multiple Myeloma is not a curable disease. Albeit autologous transplantation is currently the most effective treatment method, cytogenetic anomalies play a prognostic role in treatment successes and responses. In our study, we aimed to defire the cytogenetic abnormalities involved in risk assessment in the patient population and to whether the identified anomalies maybe predictive of spesific treatment modalites and their prognostic significance. MATERIAL AND METHODS: The study includes patients diagnosed with Multiple Myeloma who applied to the Internal Medicine Clinics of Çukurova University Faculty of Medicine between January 1, 2010, and January 1, 2023. All information about the patients was obtained from hospital automation, information technology, and hospital chemotherapy/archive files. Data were also obtained from the Departments of Medical Pathology and Medical Genetics. We identified 652 patients diagnosed with Multiple Myeloma in our hospital. 98 cases with cytogenetıc anomaly data were identified. And the data of 68 of then were found suitable for evaluation. RESULTS: The rate of cytogenetic anomalies among patients diagnosed with Multiple Myeloma in our hospital is 15.03%. The most common anomaly observed is p53 deletion, and the most common translocation is t(11,14). There was no significant difference in response rates and average survival between specific cytogenetic anomalies and specific treatment modalities. Based on this, cytogenetic anomalies were categorized as high-low risk, and chemotherapies were grouped as bortezomib-lenalidomide-cyclophosphamide-based. However, no significant difference was observed in the analysis of cytogenetic anomalies in treatment response and overall survival. In the analysis of chemotherapies, starting lenalidomide-based treatments showed a significant difference in patients' life-death statuses compared to treatments without lenalidomide. Despite no significant difference in overall survival among treatments, lenalidomide-based treatments independently increased the average survival by 14 times, regardless of the type of cytogenetic anomaly. CONCLUSION: In conlusion, regardless of the chemotherapy applied in the treatment of cytogenetıc anomalies, lenalidomid based therapy should be initiateid in patients with detected cytogenetic abnormalities. Due to retrospective nature of our study, inadequacies in the patient record system for accurate date analysis, and the limited number for patients, there is need for studies including a larger number of patients. Keywords: Multiple Myeloma, Cytogenetic anomalies, Lenalidomide