I´m 64 years old and I was diagnosed one year ago.
My onco told me that I am a high risk patient because of the del17 aberration?!
What does he mean?
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Re: del17
Dear seldom,
The del17 aberration refers to a missing copy of chromosome 17 (or at a minimum the short arm of chromosome 17) in your myeloma cells (this is NOT something that you have had since birth).
Generally speaking, myeloma that harbors a deletion of chromosome 17 is a more aggressive version of multiple myeloma. It typically responds to therapy as well as other myelomas, but comes out of remission more quickly.
Whether this should be viewed as high risk or VERY high risk depends in part on whether you have other high risk cytogenetic (chromosome) abnormalities on bone marrow testing, high International stage, etc. Another important caveat is that, at least in the French data, the proportion of the myeloma cells that contain the chromosome 17 deletion has an impact on the prognosis. If more than 60% of the myeloma cells contain this abnormality, the disease is more difficult to treat. If fewer than 60% of the myeloma cells have this abnormality, the prognosis is better.
With high risk disease, it is important that you and your physician take an aggressive and comprehensive approach to your treatment. Also, I would have a low threshold for considering clinical studies in which newer, promising agents are incorporated into existing myeloma therapy.
Best of luck to you and let us know if we can help in any other way!
Pete V.
The del17 aberration refers to a missing copy of chromosome 17 (or at a minimum the short arm of chromosome 17) in your myeloma cells (this is NOT something that you have had since birth).
Generally speaking, myeloma that harbors a deletion of chromosome 17 is a more aggressive version of multiple myeloma. It typically responds to therapy as well as other myelomas, but comes out of remission more quickly.
Whether this should be viewed as high risk or VERY high risk depends in part on whether you have other high risk cytogenetic (chromosome) abnormalities on bone marrow testing, high International stage, etc. Another important caveat is that, at least in the French data, the proportion of the myeloma cells that contain the chromosome 17 deletion has an impact on the prognosis. If more than 60% of the myeloma cells contain this abnormality, the disease is more difficult to treat. If fewer than 60% of the myeloma cells have this abnormality, the prognosis is better.
With high risk disease, it is important that you and your physician take an aggressive and comprehensive approach to your treatment. Also, I would have a low threshold for considering clinical studies in which newer, promising agents are incorporated into existing myeloma therapy.
Best of luck to you and let us know if we can help in any other way!
Pete V.
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Dr. Peter Voorhees - Name: Peter Voorhees, M.D.
Beacon Medical Advisor
Re: del17
My father also has the del17/p53 issue, which as you said puts him at a higher risk for relapse.
Right now he is responding very well to his induction treatment.
I have 2 questions:
1. I understand that this chromosome abnormality is not something he was born with. However, my dad has struggled with the fact that his multiple myeloma was not diagnosed sooner...if it had been diagnosed sooner and treatment started earlier, could that have prevented this chromosome change? Not that it makes a difference now but maybe it would help him move on if he knew it wouldn't have mattered,
2. Stem cell transplant...I undertstand this is still an option for my dad but am wondering what studies are showing for the efficacy of a SCT for high-risk patients vs. utilizing the novel therapies?
Thank you!
Right now he is responding very well to his induction treatment.
I have 2 questions:
1. I understand that this chromosome abnormality is not something he was born with. However, my dad has struggled with the fact that his multiple myeloma was not diagnosed sooner...if it had been diagnosed sooner and treatment started earlier, could that have prevented this chromosome change? Not that it makes a difference now but maybe it would help him move on if he knew it wouldn't have mattered,
2. Stem cell transplant...I undertstand this is still an option for my dad but am wondering what studies are showing for the efficacy of a SCT for high-risk patients vs. utilizing the novel therapies?
Thank you!
-
ideesmom5
Re: del17
Hello ideesmom5,
I am very sorry to hear that your father has myeloma.
I don't really know enough to answer your first question.
I think that, about your second question, it is safe to say that most doctors would say a transplant is a good idea for a patient with high risk cytogenetics. Most docs also would probably say a transplant sooner rather than later also is a good idea for a high risk patient.
A key issue will be your father's age and his general health. If he is much older than 70, or even if he is younger, but in poor general health, then a transplant may not be so good an idea.
There were two columns here at the Beacon by Dr Rajkumar of Mayo that you may find useful.
The first is exactly about transplantation:
https://myelomabeacon.org/news/2011/08/05/role-of-autologous-stem-cell-transplantation-in-multiple-myeloma/
The other is more about Dr Rajkumar's general way of treating patients:
https://myelomabeacon.org/news/2010/12/03/risk-adapted-therapy-for-multiple-myeloma-by-dr-vincent-rajkumar/
Theres also a poll going on right now here in the forum about how tough it is to get a stem cell transplant. You may find it useful too.
https://myelomabeacon.org/forum/weekly-poll-the-challenge-of-an-auto-stem-cell-transplant-t731.html
I hope your father responds really well to his treatment.
I am very sorry to hear that your father has myeloma.
I don't really know enough to answer your first question.
I think that, about your second question, it is safe to say that most doctors would say a transplant is a good idea for a patient with high risk cytogenetics. Most docs also would probably say a transplant sooner rather than later also is a good idea for a high risk patient.
A key issue will be your father's age and his general health. If he is much older than 70, or even if he is younger, but in poor general health, then a transplant may not be so good an idea.
There were two columns here at the Beacon by Dr Rajkumar of Mayo that you may find useful.
The first is exactly about transplantation:
https://myelomabeacon.org/news/2011/08/05/role-of-autologous-stem-cell-transplantation-in-multiple-myeloma/
The other is more about Dr Rajkumar's general way of treating patients:
https://myelomabeacon.org/news/2010/12/03/risk-adapted-therapy-for-multiple-myeloma-by-dr-vincent-rajkumar/
Theres also a poll going on right now here in the forum about how tough it is to get a stem cell transplant. You may find it useful too.
https://myelomabeacon.org/forum/weekly-poll-the-challenge-of-an-auto-stem-cell-transplant-t731.html
I hope your father responds really well to his treatment.
5 posts
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