Table 1.

Abnormality	Frequency	Prognosis
Hyperdiploidy	50%–60%	Good/neutral
t(4;14)	15%	Poor (neutral if bortezomib-based therapy)
t(11;14)	20%	Neutral
t(14;16)	3%	Poor/neutral
Monosomy 13	45%	Neutral
del(17p)	8%	Poor
1q gain	35%	Poor
del(1p)	30%	Poor
5q gain	50%	Good
del(12p)	10%	Poor

Recurrent Cytogenetic Changes in Myeloma

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Author(s)

Jill Corre, MD

Centre Hospitalier Universitaire, Université, Toulouse, France

Disclosures

Disclosure: Jill Corre, MD, has disclosed no relevant financial relationships.

Hervé Avet-Loiseau, MD, PhD

Centre Hospitalier Universitaire, Université, Nantes, France

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Disclosure: Hervé Avet-Loiseau, MD, PhD, has disclosed no relevant financial relationships.

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Kerrin M. Green, MA

Assistant Managing Editor, Journal of the National Comprehensive Cancer Network

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Disclosure: Kerrin M. Green, MA, has disclosed no relevant financial relationships.

CME Author(s)

Charles P. Vega, MD

Health Sciences Clinical Professor; Residency Director, Department of Family Medicine, University of California, Irvine

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Disclosure: Charles P. Vega, MD, has disclosed no relevant financial relationships.

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Nafeez Zawahir, MD

CME Clinical Director, Medscape, LLC

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Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

Sarah Fleischman

CME Program Manager, Medscape, LLC

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Disclosure: Sarah Fleischman has disclosed no relevant financial relationships.

CME

The Impact of Genomics on the Management of Myeloma

Authors: Jill Corre, MD; Hervé Avet-Loiseau, MD, PhD
CME Released: 10/7/2011
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 10/7/2012, 11:59 PM EST

Start Activity

Target Audience and Goal Statement

This activity is intended for oncologists, geneticists, and other physicians who care for patients with multiple myeloma.

The goal of this activity is to evaluate the genomics of multiple myeloma and their clinical applicability.

Upon completion of this activity, participants will be able to:

Distinguish the most common genetic abnormality in multiple myeloma
Analyze how specific genetic abnormalities affect the prognosis of multiple myeloma
Evaluate how genetic findings in multiple myeloma can affect the choice of treatment

Disclosures

Author(s)

Jill Corre, MD

Centre Hospitalier Universitaire, Université, Toulouse, France

Disclosures

Disclosure: Jill Corre, MD, has disclosed no relevant financial relationships.

Hervé Avet-Loiseau, MD, PhD

Centre Hospitalier Universitaire, Université, Nantes, France

Disclosures

Disclosure: Hervé Avet-Loiseau, MD, PhD, has disclosed no relevant financial relationships.

Editor(s)

Kerrin M. Green, MA

Assistant Managing Editor, Journal of the National Comprehensive Cancer Network

Disclosures

Disclosure: Kerrin M. Green, MA, has disclosed no relevant financial relationships.

CME Author(s)

Charles P. Vega, MD

Health Sciences Clinical Professor; Residency Director, Department of Family Medicine, University of California, Irvine

Disclosures

Disclosure: Charles P. Vega, MD, has disclosed no relevant financial relationships.

CME Reviewer(s)

Nafeez Zawahir, MD

CME Clinical Director, Medscape, LLC

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Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

Sarah Fleischman

CME Program Manager, Medscape, LLC

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Disclosure: Sarah Fleischman has disclosed no relevant financial relationships.

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Abstract and Introduction

Abstract

Myeloma is a complex disease, characterized by a wide heterogeneity in clinical presentation, evolution, and molecular portraits. The successive use of cytogenetics, molecular cytogenetics, expression genomics, copy number genomics, and, more recently, deep sequencing, has shown that this heterogeneity can be used to identify markers usable for not only prognostication but also therapeutic choice and, ultimately, discovery of druggable targets. The use of some of these techniques is now mandatory for the management of patients. Although risk-adapted therapy is not yet a routine practice in myeloma, these molecular changes are essential for the definition of the prognosis. (JNCCN 2011;9:1200–1207)

Introduction

Despite major improvements in the prognosis of multiple myeloma in the past decade (mainly because of the availability of novel drugs, such as thalidomide, bortezomib, and lenalidomide), patient outcomes are highly heterogeneous. Even though the median survival of the youngest patients is probably now more than 10 years, some patients are still presenting with refractory disease, with a fatal evolution within weeks or months. Many factors can drive this evolution. Apart from patient-related factors, such as comorbidities (including poor performance status and cardiac, renal, or liver dysfunctions), the most important heterogeneity is related to intrinsic malignant plasma cell variations. The basis of this heterogeneity is probably within the wide spectrum of molecular rearrangements observed in the malignant plasma cells. During the past decade, many studies exploring genetic rearrangements have been published. This article addresses the abnormalities that could be used in the management of patients with myeloma.

Page 1 of 6

Pathogenesis

CME Information

References

References

Disclaimer

The material presented here does not necessarily reflect the views of Medscape, LLC, or companies that support educational programming on www.medscape.org. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or employing any therapies described in this educational activity.

Published by Harborside Press

Table 1.

References

Faculty and Disclosures

Author(s)

Jill Corre, MD

Hervé Avet-Loiseau, MD, PhD

Editor(s)

Kerrin M. Green, MA

CME Author(s)

Charles P. Vega, MD

CME Reviewer(s)

Nafeez Zawahir, MD

Sarah Fleischman

CME

The Impact of Genomics on the Management of Myeloma

Target Audience and Goal Statement

Disclosures

Author(s)

Jill Corre, MD

Hervé Avet-Loiseau, MD, PhD

Editor(s)

Kerrin M. Green, MA

CME Author(s)

Charles P. Vega, MD

CME Reviewer(s)

Nafeez Zawahir, MD

Sarah Fleischman

Accreditation Statements

For Physicians

Instructions for Participation and Credit

The Impact of Genomics on the Management of Myeloma

Abstract and Introduction

Abstract

Introduction

Table of Contents