Identification of High Serum Apolipoprotein A1 As a Favorable Prognostic Indicator in Patients with Multiple Myeloma

Abstract Purpose To explore the prognostic significance of serum lipid profiles in patients with multiple myeloma (MM). Patients and methods The study retrospectively enrolled 307 MM patients in Zhongshan Hospital, Shanghai, China, from 2007 to 2016. We evaluated the prognostic significance of the prediagnostic serum lipid profile [cholesterol, triglyceride, low-density lipoprotein (LDL), high-density lipoprotein (HDL), Apolipoprotein A1 (Apo A1) and Apolipoprotein B (Apo B)]. Prognostic factors identified through univariate and multivariate analysis were used to construct a new model based on Lasso Cox regression. Results In our cohort, lipid levels showed significant difference between ISS stages (P<0.001 in cholesterol, P<0.001 in LDL, P=0.002 in HDL, P<0.001 in Apo A1, P<0.001 in Apo B). However, only Apo A1 showed statistically significance in overall survival (OS), progression free survival (PFS) and cause specific survival (CSS) (P=0.038, P=0.028, P=0.011) in univariate Cox regression. Patients with higher Apo A1 displayed longer OS (median OS, 67 months vs. 30 months; P<0.001). Also, Apo A1 was revealed to be independent prognostic parameters through multivariate analysis. Combining the Apo A1 level, a Zhongshan Score model was constructed with Lasso regression for prognosis prediction. This model exhibited higher accuracy than International Staging System (ISS) and Durie and Salmon (DS) system. Conclusion Among all the serum lipid profiles, serum Apo A1 is a powerful prognostic indicator for patients with MM. Disclosures No relevant conflicts of interest to declare.

Download Full-text

A New Prediction Model Integrated Serum Lipid Profile for Patients with Multiple Myeloma

10.21203/rs.3.rs-1039586/v1 ◽

2021 ◽

Author(s):

Huizhong Wang ◽

Biyun Chen ◽

Ruonan Shao ◽

Wenjian Liu ◽

Lang Xiong ◽

...

Keyword(s):

Multiple Myeloma ◽

Risk Score ◽

Factor Model ◽

Area Under The Curve ◽

Density Lipoprotein ◽

Staging System ◽

Apolipoprotein A1 ◽

Cancer Center ◽

Lasso Regression ◽

Apo B

Abstract This study aimed to explore a predictive risk-stratification model combing clinical characteristics and lipid profiles in multiple myeloma (MM) patients. The data of 275 patients in Sun Yat-Sen University Cancer Center were retrospectively analyzed and randomly divided into the training (n = 138) and validation (n = 137) cohorts. Triglyceride, low-density lipoprotein (LDL), high-density lipoprotein (HDL), lactate dehydrogenase (LDH), Apolipoprotein B (Apo B) and Apo B / Apolipoprotein A1 (Apo A1) ratio were the prognostic factors identified through univariate and multivariate Cox analysis. A 6-prognostic factor model was constructed based on Lasso regression. Patients were divided into low- and high-risk groups and the former group showed longer overall survival (OS) time (p<0.05). The area under the curve (AUC) of the risk score model for 5-and 10-year OS were 0.756 [95% CI: 0.661-0.850] and 0.940 [95% CI: 0.883-0.997], which exhibited better accuracy than International Staging System (ISS) and Durie and Salmon (DS) stage. The nomogram integrating ISS stage and risk score increased the prediction accuracy. The model can be used to help monitor the metabolic state and to establish primary prevention strategies to identify new therapeutic targets.

Download Full-text

Serum Apolipoprotein B/apolipoprotein A1 Ratio in Relation to Intervertebral Disc Herniation : A Cross-sectional Frequency-Matched Case-Control Study

10.21203/rs.3.rs-113468/v1 ◽

2020 ◽

Author(s):

Fei Chen ◽

Tongde Wu ◽

Song Guo ◽

Junwen Huang ◽

Qiang Fu ◽

...

Keyword(s):

Apolipoprotein B ◽

Serum Lipid ◽

Density Lipoprotein ◽

Apolipoprotein A1 ◽

Lipoprotein Cholesterol ◽

Control Group ◽

Lipid Levels ◽

Apo B ◽

Serum Lipid Levels ◽

Apo Ai

Abstract BackgroundIn recent decades, the serum lipid profile of apolipoprotein(a) (Lp(a)) level and apolipoprotein B/apolipoprotein A1 ratio (Apo B/ApoA1) ratio were found more representative for serum lipid level and were recognized as the independent risk factors for various diseases. Although the serum lipid levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) were found associated with symptomatic IDH, no studies have been conducted to date for the evaluation of the association of Apo AI, Apo B, Lp(a) and Apo B/Apo AI levels with symptomatic IDH.MaterialsA total of 1,839 Chinese patients were recruited in the present study. 918 patients were diagnosed as IDH cases and were enrolled in the experimental group. A control group of 921 patients underwent a physical examination during the same period. The serum lipid levels of TC, TG, LDL-C, HDL-C, Lp(a), Apo B and Apo B/Apo AI were examined and analyzed.ResultsThe patients in the control group were collected randomly from patients who were matched with the baseline levels of the aforementioned lipid molecular. The patients with IDH exhibited significantly higher TC, TG, LDL, Apo B and Lp(a) levels compared with the control subjects. The percentage of high-TC, high-TG, high-LDL, high-Apo B and high-Lp(a) were significantly higher in the IDH group. However, hyperlipidaemia was not associated with the degenerated segment of the IDH (P=0.201). The odds ratios (OR) for the incidence of IDH with an elevated LDL-C, TC, TG, Lp(a), Apo B and Apo B/Apo AI were 1.583, 1.74, 1.62, 1.58, 1.49 and 1.39, respectively. The correlation analysis revealed the correlation between elevated LDL-C, TC, TG, Apo B, Lp(a) and incidence of IDH was significant (R2LDL=0.017; R2TC=0.004; R2TG=0.015; R2Apo B=0.004; R2LP(a)=0.021) (P<0.05). ConclusionsThe present study suggests that elevated levels of serum TC, TG, LDL, Apo B, Lp(a) and Apo B/Apo AI are associated with a higher risk for IDH.

Download Full-text

Serum apolipoprotein B/apolipoprotein A1 ratio in relation to intervertebral disk herniation: a cross-sectional frequency-matched case–control study

Lipids in Health and Disease ◽

10.1186/s12944-021-01502-z ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Fei Chen ◽

Tongde Wu ◽

Chong Bai ◽

Song Guo ◽

Wenjun Huang ◽

...

Keyword(s):

Serum Lipid ◽

Density Lipoprotein ◽

Intervertebral Disk ◽

Apolipoprotein A1 ◽

Control Group ◽

Lipid Levels ◽

Cross Sectional ◽

Apo B ◽

Intervertebral Disk Herniation ◽

Apo Ai

Abstract Study design This was a cross-sectional frequency-matched case–control study. Background and aim The serum lipid profile of lipoprotein(a) [Lp(a)] level and apolipoprotein B/apolipoprotein A1 ratio (Apo B/Apo A1) ratio were found to be more representative for serum lipid level and were recognized as the independent risk factors for various diseases. Although the blood levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were found to be associated with symptomatic intervertebral disk herniation (IDH), no studies to date have evaluated the association of Apo AI, Apo B, Lp(a), and Apo B/Apo AI levels with symptomatic IDH. This study aimed to assess the link between blood lipid levels and symptomatic IDH. Method The study included 1839 Chinese patients. Of these, 918 patients were diagnosed with IDH and enrolled in the experimental group. A control group of 921 patients underwent a physical examination during the same period. The serum lipid levels of TC, TG, LDL-C, HDL-C, Lp(a), Apo B, and Apo B/Apo AI were examined and analyzed. The control group comprised randomly selected patients who met the baseline levels of the aforementioned lipid molecules. Results Patients with IDH exhibited significantly higher TC, TG, LDL, Apo B, and Lp(a) levels than controls. The percentage of high TC, high TG, high LDL, high Apo B, and high Lp(a) were obviously higher in the IDH group than in the control group. However, hyperlipidemia had no relationship with the degenerated segment of the IDH (P = 0.201). The odds ratio (OR) for the incidence of IDH with elevated levels of LDL-C, TC, TG, Lp(a), Apo B, and Apo B/Apo AI was 1.583, 1.74, 1.62, 1.58, 1.49, and 1.39, respectively. The correlation analysis revealed the correlation between elevated LDL-C, TC, TG, Apo B, Lp(a), and incidence of IDH was significant (R2LDL = 0.017; R2TC = 0.004; R2TG = 0.015; R2Apo B = 0.004; R2Lp(a) = 0.021) (P < 0.05). Conclusion This study suggested that elevated levels of serum TC, TG, LDL, Apo B, Lp(a), and Apo B/Apo AI were associated with a higher risk of IDH. This study provided useful information to identify a population that might be at risk of developing IDH based on elevated lipid levels.

Download Full-text

Serum Apolipoprotein B/Apolipoprotein A1 Ratio In Relation To Intervertebral Disc Herniation: A Cross-Sectional Frequency-Matched Case-Control Study

10.21203/rs.3.rs-113468/v2 ◽

2021 ◽

Author(s):

Fei Chen ◽

Tongde Wu ◽

Chong Bai ◽

Song Guo ◽

Junwen Huang ◽

...

Keyword(s):

Serum Lipid ◽

Density Lipoprotein ◽

Apolipoprotein A1 ◽

Control Group ◽

Intervertebral Disc Herniation ◽

Cross Sectional ◽

Apo B ◽

Matched Case ◽

Control Study ◽

Apo Ai

Abstract Study Design:A cross-sectional frequency-matched case-control studyObjective: In recent decades, the serum lipid profile of apolipoprotein(a) (Lp(a)) level and apolipoprotein B/apolipoprotein A1 ratio (Apo B/ApoA1) ratio were found more representative for serum lipid level and were recognized as the independent risk factors for various diseases. Although the serum lipid levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) were found associated with symptomatic intervertebral disc herniation (IDH), no studies have been conducted to date for the evaluation of the association of Apo AI, Apo B, Lp(a) and Apo B/Apo AI levels with symptomatic IDH.Method: A total of 1,839 Chinese patients were recruited in the present study. 918 patients were diagnosed as IDH cases and were enrolled in the experimental group. A control group of 921 patients underwent a physical examination during the same period. The serum lipid levels of TC, TG, LDL-C, HDL-C, Lp(a), Apo B and Apo B/Apo AI were examined and analyzed. The patients in the control group were collected randomly from patients who were matched with the baseline levels of the aforementioned lipid molecular.Results: The patients with IDH exhibited significantly higher TC, TG, LDL, Apo B and Lp(a) levels compared with the control subjects. The percentage of high-TC, high-TG, high-LDL, high-Apo B and high-Lp(a) were significantly higher in the IDH group. However, hyperlipidaemia was not associated with the degenerated segment of the IDH (P=0.201). The odds ratios (OR) for the incidence of IDH with an elevated LDL-C, TC, TG, Lp(a), Apo B and Apo B/Apo AI were 1.583, 1.74, 1.62, 1.58, 1.49 and 1.39, respectively. The correlation analysis revealed the correlation between elevated LDL-C, TC, TG, Apo B, Lp(a) and incidence of IDH was significant (R2LDL=0.017; R2TC=0.004; R2TG=0.015; R2Apo B=0.004; R2LP(a)=0.021) (P<0.05).Conclusion:The present study suggests that elevated levels of serum TC, TG, LDL, Apo B, Lp(a) and Apo B/Apo AI are associated with a higher risk for IDH.

Download Full-text

Cardiovascular risk according to plasma apolipoprotein and lipid profiles in a Canadian First Nation

Chronic Diseases in Canada ◽

10.24095/hpcdp.31.1.06 ◽

2010 ◽

Vol 31 (1) ◽

pp. 33-38 ◽

Cited By ~ 1

Author(s):

ND Riediger ◽

SG Bruce ◽

TK Young

Keyword(s):

Cardiovascular Risk ◽

First Nations ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Age Groups ◽

Density Lipoprotein ◽

Lipid Profiles ◽

Apolipoprotein A1 ◽

First Nation ◽

Future Research

Introduction Despite high diabetes rates among Canadian First Nations people, little is known about their cardiovascular disease risk. Our aim was to describe the apolipoprotein profile with respect to cardiovascular risk in a Canadian First Nation community. Methods In 2003, a representative sample of adult members of a Manitoba First Nation (N = 483) participated in a screening study for diabetes and diabetes complications. We assessed their cardiovascular risk factors. Results Sixty percent of women were at increased cardiovascular risk because of low apolipoprotein A1 (apoA1) levels, compared with 35% of men. The proportion of women with low apoA1 levels decreased with age, but the proportion with low high-density lipoprotein levels remained stable across age groups. Both apoB and apoA1 were significantly associated with obesity when age, sex, diastolic blood pressure, homocysteine, diabetes, and insulin resistance were controlled for. Conclusion Apolipoprotein and lipid profiles in this First Nation population suggest high cardiovascular risk. Future research should characterize the lipoprotein particle size in this population.

Download Full-text

The difference of lipid profiles between psoriasis with arthritis and psoriasis without arthritis and sex-specific downregulation of methotrexate on the apolipoprotein B/apolipoprotein A-1 ratio

Arthritis Research & Therapy ◽

10.1186/s13075-021-02715-4 ◽

2022 ◽

Vol 24 (1) ◽

Author(s):

Bing Wang ◽

Hui Deng ◽

Yao Hu ◽

Ling Han ◽

Qiong Huang ◽

...

Keyword(s):

Inflammatory Marker ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Severity Index ◽

Lipid Profiles ◽

Apolipoprotein A1 ◽

Concomitant Disease ◽

Psoriasis Area Severity Index ◽

Male Patients ◽

The Difference

Abstract Background Methotrexate (MTX) has a protective effect against cardiovascular diseases (CVD), but the mechanism is unclear. Objective To investigate the effect of MTX on lipid profiles and the difference between psoriasis without arthritis (PsO) and psoriatic arthritis (PsA). Methods In this prospective study, we recruited 288 psoriatic patients (136 PsA and 152 PsO) who completed 12 weeks of MTX treatment. Total cholesterol (TC), triglycerides (TG), lipoprotein A [LP(a)], high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL), apolipoprotein A1 (ApoA1), and ApoB were measured. Results Compared with sex- and age-matched healthy controls, psoriatic patients had significantly (p < 0.0001) higher levels of proatherogenic lipids and lower levels of anti-atherogenic lipids. PsA patients had a higher ApoB/ApoA1 ratio than PsO patients (p < 0.05). Stepwise regression analysis found a positive correlation between the inflammatory marker hCRP and the Psoriasis Area Severity Index (PASI), ApoB/ApoA1 ratio, BMI, and smoking. ApoB was positively associated with concomitant arthritis, diabetes, and hypertension. MTX decreased the levels of pro-atherogenic and anti-atherogenic lipids. However, a significant reduction of the ApoB/ApoA1 ratio by MTX was only observed in male patients. Conclusion PsA patients had a significantly higher percentage of concomitant disease than PsO. The decrease of MTX on CVD might be related with sex. Trial registration ChiCTR2000036192

Download Full-text

The effects of eight serum lipid biomarkers on age-related macular degeneration risk: a Mendelian randomization study

International Journal of Epidemiology ◽

10.1093/ije/dyaa178 ◽

2020 ◽

Author(s):

Xikun Han ◽

Jue-Sheng Ong ◽

Alex W Hewitt ◽

Puya Gharahkhani ◽

Stuart MacGregor

Keyword(s):

Macular Degeneration ◽

Serum Lipid ◽

Mendelian Randomization ◽

Density Lipoprotein ◽

Lipid Biomarkers ◽

Age Related Macular Degeneration ◽

Apolipoprotein A1 ◽

Lipoprotein Cholesterol ◽

European Descent ◽

Age Related

Abstract Background Age-related macular degeneration (AMD) is a leading cause of vision loss. Whereas lipids have been studied extensively to understand their effects on cardiovascular diseases, their relationship with AMD remains unclear. Methods Two-sample Mendelian randomization (MR) analyses were performed to systematically evaluate the causal relationships between eight serum lipid biomarkers, consisting of apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), total cholesterol (CHOL), high-density lipoprotein cholesterol (HDL-C), direct low-density lipoprotein cholesterol (LDL-C), lipoprotein A [Lp(a)], triglycerides (TG) and non-HDL cholesterol (non-HDL-C), and the risk of different AMD stages and subtypes. We derived 64–407 genetic instruments for eight serum lipid biomarkers in 419 649 participants of European descent from the UK Biobank cohort. We conducted genome-wide association studies (GWAS) for 12 711 advanced AMD cases [8544 choroidal neovascularization (CNV) and 2656 geographic atrophy (GA) specific AMD subtypes] and 5336 intermediate AMD cases with 14 590 controls of European descent from the International AMD Genomics Consortium. Results Higher genetically predicted HDL-C and ApoA1 levels increased the risk of all AMD subtypes. LDL-C, ApoB, CHOL and non-HDL-C levels were associated with decreased risk of intermediate and GA AMD but not with CNV. Genetically predicted TG levels were associated with decreased risk of different AMD subtypes. Sensitivity analyses revealed no evidence for directional pleiotropy effects. In our multivariable MR analyses, adjusting for the effects of correlated lipid biomarkers yielded similar results. Conclusion These results suggest the role of lipid metabolism in drusen formation and particularly in AMD development at the early and intermediate stages. Mechanistic studies are warranted to investigate the utility of lipid pathways for therapeutic treatment in preventing AMD.

Download Full-text

Effect of Low Molecular Weight Heparin on Bone Metabolism and Hyperlipidemia in Patients on Maintenance Hemodialysis

The International Journal of Artificial Organs ◽

10.1177/039139880102400708 ◽

2001 ◽

Vol 24 (7) ◽

pp. 447-455 ◽

Cited By ~ 33

Author(s):

K.N. Lai ◽

K. Ho ◽

R.C.K. Cheung ◽

L.C.W. Lit ◽

S.K.M. Lee ◽

...

Keyword(s):

Molecular Weight ◽

Lipid Profile ◽

Bone Metabolism ◽

Serum Lipid ◽

Low Molecular Weight Heparin ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Maintenance Hemodialysis ◽

Low Molecular Weight ◽

Apo B

The effect of low molecular weight heparin (LMWH) on serum lipid profile in hemodialysis remains controversial and its effect on bone metabolism has not been studied. A crossover study was conducted in 40 patients on stable hemodialysis using unfractionated heparin (UFH) for more than 24 months. These patients were then treated with a LMWH (nadroparin-Ca) for 8 months during hemodialysis and subsequently switched back to UFH for 12 months. Serum lipid profile, biochemical markers for bone metabolism, and bone densitometry (BMD) were monitored at four-month intervals while all medications remained unchanged. Cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), lipoprotein(a) (Lp(a)), apolipoprotein B (Apo B) were raised in 35%, 29%, 12%, 24% and 24% of patients respectively. High-density lipoprotein-cholesterol (HDL-C) and apolipoprotein A1 (Apo A-1) were reduced in 47% and 9% of patients. Bone-specific alkaline phosphatase (BALP) and intact osteocalcin (OSC), both reflecting osteoblastic activity, were raised in 65% and 94% of patients. Tartrate-resistant acid phosphatase (TRACP) reflecting osteoclastic activity and parathyroid hormone (PTH) were elevated in 35% and 88% of patients. Following LMWH treatment, TC, Tg, Lp(a) and Apo B were reduced by 7%, 30%, 21% and 10% respectively (p<0.05 or <0.01) while Apo A-1 were raised by 7% (p<0.01). Simultaneously, TRACP was reduced by 13% (p<0.05). These biochemical changes were detected soon after 4 months of LMWH administration. Although BMD values in our patients were lower than those of age-matched normal subjects, significant changes were not observed with LMWH treatment. After switching back to UFH for hemodialysis, these biochemical indices reverted to previous values during UFH treatment with a significant higher level in TC and Apo B while serum Apo A-1 remained elevated. Our study suggests LMWH may partially alleviate hyperlipidemia and, perhaps, osteoporosis associated with UFH administration in patients on maintenance hemodialysis.

Download Full-text

Prognostic significance of ADAM17 expression in patients with gastric cancer who underwent curative gastrectomy.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.60 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 60-60

Author(s):

Ahmet Bilici ◽

Dincer Aydin ◽

Dilek Yavuzer ◽

Hatice Odabas ◽

Ozlem Ercelep ◽

...

Keyword(s):

Gastric Cancer ◽

Multivariate Analysis ◽

Molecular Marker ◽

Cancer Progression ◽

Prognostic Significance ◽

Disease Free Survival ◽

Prognostic Indicator ◽

Curative Gastrectomy ◽

Prognostic Importance ◽

Gastric Cancer Patients

60 Background: Tumor invasion and metastasis are complex processes, involving regulation at the molecular level of adhesive molecules, proteolitic enzymes, and cell growth and angiogenesis factors. A Disintegrin and Metalloproteinase (ADAM)17 has been indicated to be indispensable regulator of celular event from proliferation to migration.Although prognostic importance of ADAM17 expression has been investigated in several tumors, its clinical utility as a useful prognostic molecular marker remains unclearin gastric cancer.In the present study, we evaluated the expression of ADAM17 and its prognostic significance in gastric cancer patients after surgery. Methods: Prognostic significance of ADAM17 expression was analyzed by immunohistochemically in 158 patients with gastric cancer and the relationship between its expression and clinicopathological factors was also evaluated. Results: High expression of ADAM17 was detected in 81 patients(51%),while low expression was found in 77 cases (49%). There was significant correlation between gender, histology, lymph node metastasis, vascular invasion, the presence of recurrence and high ADAM17 expression. Recurrence in patients with high ADAM17 expression was significantly higher than that for patients with low ADAM17 expression(p=0.032). The median disease-free survival (DFS) time for patients with high ADAM17 expressed tumors were worse than those of patients with low ADAM17 expressed tumor (16.6 vs. 44.2 months, p=0.004).In addition, patients with low ADAM17 expression had a higher median overall survival (OS)interval than those of high ADAM17 expressed patients (49.6 vs. 26.9 months, p=0.019). Multivariate analysis indicated that the rate of ADAM17 expression was an independent prognostic factor for DFS, in addition to known important clinicopathological prognostic indicator for DFS. But its' prognostic importance could not be proved by multivariate analysis for OS. Conclusions: The potential value of ADAM17 expression as a useful molecular marker in gastric cancer progression should be evaluated comprehensively,it may predict recurrence and poor prognosis in patients with gastric cancer after curative resection.

Download Full-text

Prognostic significance of t(11;14) expression by FISH in patients with newly diagnosed multiple myeloma in the era of novel therapies.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e19525 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e19525-e19525

Author(s):

Miguel Gonzalez Velez ◽

Ricardo Daniel Parrondo ◽

Tracy Andrews ◽

Narjust Duma ◽

Joshua Ryan Richter ◽

...

Keyword(s):

Multiple Myeloma ◽

Cox Regression ◽

Prognostic Significance ◽

Progression Free Survival ◽

Autologous Stem Cell Transplant ◽

Cell Transplant ◽

Novel Therapies ◽

Newly Diagnosed ◽

Seer Data ◽

Worse Prognosis

e19525 Background: Rearrangements of the immunoglobulin heavy chain (IGH) on chromosome 14 are identified by FISH in about 15-20% of patients (pts) with newly diagnosed multiple myeloma (MM). Historically there is variation on the significance on prognosis of these rearrangements: typically, t(4;14), t(14;16) and t(14;20) have high risk (HR), and t(11;14) have standard risk (SR). A recent study (Kaufman et al, Leukemia. 2016 30:633-9) suggests that t(11;14) may confer a worse prognosis We report the prognostic significance of t(11;14) in a single-institution MM cohort. Methods: 87 pts with t(11;14) by CD 138 selected FISH at diagnosis were identified, pts without symptomatic MM were excluded. Cox regression was used for statistical analysis. Progression free survival (PFS), and overall survivals (OS) from diagnosis and post autologous stem cell transplant (ASCT) were analyzed by Kaplan-Meier. Results: Median age at diagnosis was 62 years, 45 pts (52%) were male, and 24 pts (27%) had ISS 3. All pts received either a proteasome inhibitor or an immunomodulatory agent, and 42 (48%) received triplet treatment as induction. Sixty-nine (79%) pts had ASCT, and overall response rate (ORR, partial response or better) post ASCT was 73%. For pts with HR FISH (defined as t(14;16), p53 del, 1q21 gain or 1p del) compared to SR FISH, the ORR post ASCT was 70% vs 77% (p = 0.67). OS from diagnosis was 93% at 3 years, 74% at 4 years and 51% at 5 years. Seven patients (8%) developed plasma cell leukemia, and there was no association between HR and SR FISH (p = 0.66). In multivariate analysis, ISS stage was an independent risk factor for mortality; pts with stage 3 had 7.3 times (CI: 1.16-36.4) and 5.7 times (CI: 1.63-20.0) the risk of mortality than pts with stage 1 and 2. Having an ASCT reduced mortality by 87% (CI: 0.04-0.41). Conclusions: Despite the use of novel therapies the OS at 5 years of our pts with MM was not significantly improved compared to SEER data from 1992-2013 (51% vs 48.5%). Pts with t(11;14) who had ASCT had increased survival compared to those who did not. Our results suggest that t(11;14) may confer a worse prognosis. Further prospective studies evaluating the risk of t(11;14) are warranted.

Download Full-text