You are leaving Medscape Education
Cancel Continue
Log in to save activities Your saved activities will show here so that you can easily access them whenever you're ready. Log in here CME & Education Log in to keep track of your credits.

Table 1.  

Abnormality Frequency Prognosis
Hyperdiploidy 50%–60% Good/neutral
t(4;14) 15% Poor (neutral if
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


The Impact of Genomics on the Management of Myeloma

  • Authors: Jill Corre, MD; Hervé Avet-Loiseau, MD, PhD
  • CME Released: 10/7/2011
  • 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:

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


As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.


  • Jill Corre, MD

    Centre Hospitalier Universitaire, Université, Toulouse, France


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

  • Hervé Avet-Loiseau, MD, PhD

    Centre Hospitalier Universitaire, Université, Nantes, France


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


  • Kerrin M. Green, MA

    Assistant Managing Editor, Journal of the National Comprehensive Cancer Network


    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


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

CME Reviewer(s)

  • Nafeez Zawahir, MD

    CME Clinical Director, Medscape, LLC


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

  • Sarah Fleischman

    CME Program Manager, Medscape, LLC


    Disclosure: Sarah Fleischman has disclosed no relevant financial relationships.

Accreditation Statements

    For Physicians

  • This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and JNCCN - The Journal of the National Comprehensive Cancer Network. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.

    Medscape, LLC designates this Journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Medscape, LLC staff have disclosed that they have no relevant financial relationships.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or printed out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. Medscape Education encourages you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

*The credit that you receive is based on your user profile.


The Impact of Genomics on the Management of Myeloma

Authors: Jill Corre, MD; Hervé Avet-Loiseau, MD, PhDFaculty and Disclosures

CME Released: 10/7/2011

Valid for credit through: 10/7/2012, 11:59 PM EST


Abstract and Introduction


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)


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.