828P - Translocation 11;14 is not associated with adverse prognosis in the era of novel anti-myeloma therapeutics

Background

Translocation t(11;14) is one of the most common primary translocations in multiple myeloma (MM). In the era of the novel anti-myeloma agents, the exact prognostic role of t(11;14) remains to be determined.

Methods

We analyzed prospectively collected data from 1011 consecutive patients with newly diagnosed MM (NDMM) in a single institution (1997-2023). Approval was obtained by the institutional ethics committee. All patients were tested for t(11;14), +1q21, t(4;14), t(14;16), del(17p), del(13q) at diagnosis using standard FISH in CD138+ selected cells. Positivity was defined as at least 20% of clonal cells harboring t(11;14).

Results

89 out of 1011 patients (8.8%) had the t(11;14). The median age was 68 years and 54% were males. Patients with t(11;14) did not have a statistically significant difference in progression-free survival (PFS) compared with those who did not had t(11;14) [hazard ratio (HR) 1.25, p=0.15]. Interestingly, patients with isolated positivity for t(11;14) did not have a statistically significant difference in PFS compared with those without any abnormalities (HR 1.28, p=0.282). However, patients with t(11;14) and at least another cytogenetic abnormality had inferior PFS (HR 1.38, p=0.001). More specifically, those with t(11;14) and del17p (HR 3.74, 95%CI: 1.53-9.17, p=0.004) and those with t(11;14) and 1q21 amplification/addition (HR 1.67, 95%CI: 1.00-2.78, p=0.05) had dismal outcomes. Similarly, there was no statistically significant difference in overall survival (OS) between patients with and without t(11;14) (HR 1.31, 95%CI: 0.86-2.00, p=0.21). Patients who had at least an additional cytogenetic abnormality had inferior OS (HR 1.68, p<0.001). Patients with isolated t(11;14) did not demonstrate inferior OS compared with those without any abnormalities (HR 0.61, p=0.33). The co-presence of del17p (HR 6.03, p<0.001) or 1q21 amplification/addition (HR 2.51, p=0.006) with t(11;14) had a detrimental impact on OS.

Conclusions

Isolated t(11;14) in patients with NDMM does not seem to be a marker of adverse prognosis, whereas the co-presence of other high-risk cytogenetic abnormalities confers dismal outcomes. For those patients, BCL-2 targeted therapies have to be validated in future studies.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.