DETECTION OF CHROMOSOMAL ABNORMALITIES IN PATIENTS WITH MULTIPLE MYELOMA BY FISH AND THEIR CORRELATION WITH CLINICAL SIGNIFICANCE AND PROGNOSTIC VALUE

Qin Huang, Min Mao, Li An, Yan Li, Xiaoyan Zhang, Ling Fu, Tao Lang, Zengsheng Wang, Yuling Nie, Xiaomin Wang^*

Department of Hematology, People’s Hospital of Xin jiang Uygur Autonomous Region, Urumqi, PR China

Objective: To detect the chromosomal abnormalities in patients with multiple myeloma (MM) by fluorescence in situ hybridization (FISH) and to explore their correlation with clinical significance and prognostic value. 

Methods: 83 MM patients who were treated in our hospital from April 2015 to January 2017 were selected as the observation group, and 12 patients with non-hematological malignant diseases who provided bone marrow specimens were selected as the control group. The IGH, 1q21, RB1, D13S319, and p53 probes were used to detect FISH in MM patients and observe chromosomal abnormalities. Correlation with clinical data (age, R-ISS stage, bone loss, white blood cells, platelets, hemoglobin, erythrocyte sedimentation, creatinine, globulin, albumin, and C-reactive protein (CRP)), clinical significance, and prognostic value were analyzed. 

Results: Among 83 patients with MM, 64 (77.11%) had chromosomal abnormalities, and 19 patients had negative test results. Among those with abnormalities, 8 cases (12.50%) had all four of the chromosomal abnormalities tested for via FISH, 17 cases (26.56%) had three kinds of abnormalities, and 16 cases (25.00%) had two kinds of abnormalities. There were 23 cases (35.94%) with only one chromosome abnormality. We found that IGH rearrangement was related to bone damage and albumin, 1q21 amplification was related to CRP, and 13q14 deletion was related to hemoglobin, albumin and globulin levels, and R-ISS stage. 17p13 deletion was significantly correlated with albumin, platelet, albumin, and globulin levels and R-ISS stages. Among the positive and negative FISH test results, the CR, PR, SD, and PD patients were significantly different in the T-VAD group (P<0.05), but not significantly different in the PAD group (P>0.05). Among the patients with chromosomal abnormalities, the treatment effect was worse than that of patients with negative results. Patients with IGH rearrangement and 17p13 deletion had significantly lower survival time. Patients with normal chromosomes had a significantly negative correlation with prognosis (P<0.05), while 1q21 amplification and 13q14 deletion had no significant correlation with patient prognosis. IGH rearrangement and 17p13 deletion are independent risk factors that affect the prognosis of this group of MM patients. 

Conclusions: Most patients with MM have chromosomal abnormalities, which are related to some specific clinical measurements. FISH test can identify patients with these abnormalities, who have poorer treatment effect and poor prognosis.