[ClassicKate]

4:14 Translocation

by ClassicKate on Mon Apr 15, 2013 3:59 pm

I am a new member to the Beacon. However, I have appreciated the Beacon website so much over the past two years. My thanks to everyone involved here.

I am 67 years old and recently learned that I have the 4:14 Translocation. It is not clear if it was present in my first bone marrow biopsy at diagnosis two years ago, since the sample was too small to do the FISH. I asked my myeloma doctor what impact this has on my prognosis and she claimed to still be "hopeful". Of course!

I would like to hear from anyone with (t) 4:14. I would appreciate anything you would like to share, such as your treatment plan, how it is going, age at diagnosis and age at the time of the 4:14 finding, any other risk factors.

I would also like to understand my FISH results better and how the 4:14, as well as other findings impact my prognosis. Here are the findings: IGH/FGFR3 fusion, translocation at 14q32 and 11q13, no detection of IGH/CCND1. Is the IGH rearrangement the same thing as the 4:14 translocation or do I have an additional risk factor? I am IGA lambda. Should I include the IGA as an additional risk?

[ClassicKate]

Re: 4:14 Translocation

by ClassicKate on Mon Apr 15, 2013 4:11 pm

Calssic Kate again, Sorry. I forgot the first location: 14q32 and 4 p16. I think this means I have a 4:14 translocation and the prior (14q32 and 11q13) means I have an 11:14 translocation.

[Dr. Adam Cohen]

Re: 4:14 Translocation

by Dr. Adam Cohen on Thu Apr 18, 2013 10:58 pm

Dear ClassicKate,
The way your report is written is a little unclear, but it sounds like you do have both (4;14) and (11;14) translocations. The (11;14) translocation is fairly common in myeloma and is thought to have minimal impact on prognosis. IgA would also not be considered a high-risk factor in current classifications. The (4;14) translocation is thought of as a higher-risk abnormality that historically has predicted for more aggressive disease. However, a number of more recent studies have suggested that prolonged treatment with the novel agents, particularly Velcade, may be especially helpful for patients with (4;14), so that these patients may do just as well as those without this translocation. So there is definitely reason to be hopeful!

[Classic Kate]

Re: 4:14 Translocation

by Classic Kate on Fri Apr 19, 2013 5:13 pm

Dr. Cohen, Thank you so much for responding and of course, for the encouragement.

My induction for SCT harvest, was RVD and I achieved CR. My stem cells were collected, but we did not transplant. At that time we were unaware of the (t) 4:14.

Six months after the harvest (no maintenance), I was restarted on Velcade/Dex (no rev yet). I have completed 1 round (22 day/ once week; 4 on, 1 off). and 2 weeks of Round 2.This time my numbers are climbing higher than ever. Currently. Lambda FLC 6300 mg/l and IGA is 2553 mg/dl Kappa FLC/ Lamda Ratio is 0.0. Is there any explanation for a good intial response with Velcade and now this poor response?

Thanks again, Kate