[Rhonda]

IgH gene rearrangement - what is that?

by Rhonda on Tue Apr 14, 2015 7:19 am

I have been following this forum for a few months now. I am very impressed with the knowl­edge shared on this site.

I have an additional copy of IgH / IgH gene rearrangement. Is this a chromosomal abnormality, or is it a possibility of becoming one? My IgH gene arrange lists several abnormal findings and I am not sure what they mean they are as follows:

FISH Results

FGRR3/IgH (t(4;14)) abnormal copy number
CEP 9 abnormal
CCND1/IgH (t(11;14)) abnormal copy number
RB1 (13q14) LAMP 1 Normal
p53 (17p13.1) CEP 17 Normal
CEP 7 abnormal
CKS1B (1q21) CDKN2C (1p32.3) abnormal
IgH/MAP (t(14;16))

Interpretation

Negative for a deletion of 1q (CDKN2C)
Positive for an additional copy of 1q(CKS1B)
Positive for Trisomy 7 and Trisomy 9
Negative for -13 and 13q-
Negative for t(11:14).t(4;14) and t(4;16)
Positive for an additional copy of CCND1 (Trisomy 11)
Positive for an additional copy of IgH (IgH gene rearrangement)

I have been told based on this I am standard risk, but am concern if the gene rearrangement changes I could quickly move to high risk.

I was diagnosed at Stage 1 and it came as a total surprise to me, as I was only slightly anemic, which led to the finding of multiple myeloma. It was like being hit by a freight train and took me several months to even want to accept the fact I will have cancer for the rest of my life!

I have another bone marrow biopsy next week as I am moving in the direction of a stem cell harvest at Stanford within the next couple months.

I asked my doctor to run another FISH test to see if anything has changed. It seems like a lot of emphasis is put in the chromosomal abnormalities when determining progression-free survival (PFS) and overall survival (OS).

Any help information I can get would be much appreciated.

Thank you for the help and let's all pray for a cure!

[Dr. James Hoffman]

Re: IgH gene rearrangement - what is that?

by Dr. James Hoffman on Tue Apr 14, 2015 9:36 am

These reports certainly can be confusing.

Seems that you have 'hyperdiploid' myeloma (meaning extra chromosomes), generally a good feature (better than too few). However, the +1q is technically an intermediate risk factor (see msmart.org). So that is how a I would characterize the report as a whole.

We see a fair number of IgH rearrangments without a typical translocation, and it is hard to assign risk to this part of the report.

Most important will be your response to treatment. Hopefully all will go well. Praying (and research­ing!) for a cure along with you ...

Last edited by Dr. James Hoffman on Tue Apr 14, 2015 3:11 pm, edited 1 time in total.

[Rhonda]

Re: IgH gene rearrangement - what is that?

by Rhonda on Tue Apr 14, 2015 3:06 pm

Thank you so much for the quick reply. This information does give me some comfort. I didn't respond well to the initial treatment of CyborD (cyclophosphamide, Velcade, and dexa­metha­sone), but have responded quite well to KRD (Kyprolis, Revlimid, and dex). I am hoping the transplant will be a success too.

Thank you again,
Rhonda