[lwem]

FISH test - 8q24 (MYC sep) & +14(3'IGH 5' IGH)X3 ?

by lwem on Thu Oct 01, 2015 2:25 pm

Hello -

I am a caregiver and have not had a clear opportunity to discuss my husband's FISH results with his physician. We have a meeting in two weeks, and am looking for assistance interpreting his results.

In particular, FISH break-apart probe had abnormal "8q24 (MYC sep)" finding and "+14(3'IGH 5' IGH)X3".

The interpretation stated that there is a "disruption of the MYC gene region" and also a trisomy 14.

Does anyone know if these findings refer to translocations? Should I be asking the oncologist about whether he has translocations of these chromosomes?

Thank you. Any help is appreciated.

lwem

[lwem]

Re: FISH test - 8q24 (MYC sep) & +14(3'IGH 5' IGH)X3 ?

by lwem on Fri Oct 02, 2015 11:31 am

Here is the entire fish result. I do understand the significance (good and bad) of the odd-numbered trisomies, 1q gain, and 13q deletion. I am seeking interpretation of the 8q24 abnormality and the trisomy 14, and whether these are translocations:

14q32 (IGH sep) Normal
t(11;14) CCND1/IGH fusion Normal
17p- (TP53x1, D17Z1x2) Normal
-17 (TP53, D17Z1)x1 Normal
-13 (RBI, LAMP1)x1 Normal
13q-(RBx1, LAMP1x2) Abnormal
8q24 (MYC sep) Abnormal
+1q(TP73x2, CKS1Bx3) Abnormal
+1(TP73, CKS1B)x3 Normal
+3(D3Z1x3) Abnormal
+7(D7Z1x3) Abnormal
+9(D9Z1x3) Normal
+9(D9Z1x4) Abnormal
+11(CCND1-XTx3) Abnormal
+14(3/IGH/5'IGH)x3 Abnormal
+15 (D15Z4x3) Abnormal

Interpretation: "duplication of the CKS1B gene region, trisomy 3, 7, 11, 14 and 15, tetrasomy 9, a 13q deletion and disruption of the MYC gene region"

Thank you for any assistance on interpreting the findings.

[Dr. Prashant Kapoor]

Re: FISH test - 8q24 (MYC sep) & +14(3'IGH 5' IGH)X3 ?

by Dr. Prashant Kapoor on Sat Oct 03, 2015 9:38 am

Dear Iwem,

I am sorry to hear about your husband's diagnosis.

The abnormalities that are identified here as "trisomies" (and one tetrasomy) are suggestive of a hyperdiploid clone (group of myeloma cells with identical genetic features). We typically see trisomies of the odd number chromosomes in myeloma, but sometimes this is accompanied by involvement of the even number chromosomes (such as chromosome 14) as well. No translocations were noted.

There is evidence of myc dysruption as well. Myc gene rearrangements can be seen in a high proportion of patients with myeloma , although their prognostic significance remains to be fully defined in myeloma. They were previously considered to be events that occur in the later stages of a patient's multiple myeloma, but have recently been reported in newly diagnosed myeloma patients as well.

The 1q21duplication is a pertinent abnormality in this report. As per Mayo Clinic's mSMART classification, it is associated with an intermediate prognostic category.

Deletion 13 on interphase on FISH is a common abnormality that is not particularly prognostic.

[lwem]

Re: FISH test - 8q24 (MYC sep) & +14(3'IGH 5' IGH)X3 ?

by lwem on Sun Oct 04, 2015 10:02 am

Thank you very much. This answers my question. I wasn't sure if the MYC disruption and the trisomy 14 were related, or whether there were unidentified partner translocations. Thank you!