"Based on the current findings, we conclude that the presence of trisomies in patients with t(4;14), t(14;16), t(14;20) or p53 deletion abnormalities in myeloma ameliorates the usual adverse impact associated with these prognostic markers."
http://www.oncologystat.com/journals/journal_scans/Trisomies_in_Multiple_Myeloma_Impact_on_Survival_In_Patients_With_High-Risk_Cytogenetics.html
Forums
10 posts
• Page 1 of 1
Re: More Good News for High Risk Cytogenetic multiple myelom
Hi Suzierose
Can you explain what a trisomy is? And why in this case are "concurrent trisomies" a good thing for patients with high-risk cytogenetics?
Thanks as always for keeping your eye on the latest news!
Can you explain what a trisomy is? And why in this case are "concurrent trisomies" a good thing for patients with high-risk cytogenetics?
Thanks as always for keeping your eye on the latest news!
Re: More Good News for High Risk Cytogenetic multiple myelom
Hi ideesmom!!
I am hoping we can learn more together from the Beacon advisors here!!
The only thing I do know for sure is that trisomy means 3 copies of a chromosome.
Due to the complexity of this, I am unable to put in clinical perspective. Or make any sense out of how this impacts multiple myeloma pathogenesis or the other negative chromosome changes positively when it comes to survival.
Beacon Advisors, can you help, please?
I am hoping we can learn more together from the Beacon advisors here!!
The only thing I do know for sure is that trisomy means 3 copies of a chromosome.
Due to the complexity of this, I am unable to put in clinical perspective. Or make any sense out of how this impacts multiple myeloma pathogenesis or the other negative chromosome changes positively when it comes to survival.
Beacon Advisors, can you help, please?
-
suzierose - Name: suzierose
- When were you/they diagnosed?: 2 sept 2011
Re: More Good News for High Risk Cytogenetic multiple myelom
In a patient with a chromosomal trisomy there are three copies, instead of the normal two, of a particular chromosome. A trisomy is an abnormal number of chromosomes.
What this study suggests is that myeloma patients who had poor risk cytogenetics but who also have at least one trisomy of an odd numbered chromosome (42% of the high risk patients in the study) have a much better prognosis that those without a trisomy.
Simply put..... a chromosomal trisomy in a myeloma patient with otherwise high risk cytogenetics seems to improve their prognosis significantly.
What this study suggests is that myeloma patients who had poor risk cytogenetics but who also have at least one trisomy of an odd numbered chromosome (42% of the high risk patients in the study) have a much better prognosis that those without a trisomy.
Simply put..... a chromosomal trisomy in a myeloma patient with otherwise high risk cytogenetics seems to improve their prognosis significantly.
-
Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
Re: More Good News for High Risk Cytogenetic multiple myelom
So would it be fair to say, in terms of multiple myeloma pathogenisis, that the extra third chromosome continues to regulate the gene it is programmed to even if the other 2 chromosomes are deleted/translocated and dysregulating the gene.
Sorta, like having a 3 man fight vs. 2? That extra man helps?
The third man (chromosome) makes up for what the other 2 might not do?
Sorta, like having a 3 man fight vs. 2? That extra man helps?
The third man (chromosome) makes up for what the other 2 might not do?
-
suzierose - Name: suzierose
- When were you/they diagnosed?: 2 sept 2011
Re: More Good News for High Risk Cytogenetic multiple myelom
New clinical data says:
"Based on the current findings, we conclude that the presence of trisomies in patients with t(4;14), t(14;16), t(14;20) or p53 deletion abnormalities in myeloma ameliorates the usual adverse impact associated with these prognostic markers."
Is it only odd numbered trisomies...or can it be any trisomy?
Are there more details that can be provided?
How would you, as a patient weigh this new data?
What kinds of lower dose therapy do you believe could be possible?
What were the therapeutic agents patients were on who demonstrated an ameloriate effect ( longer median OS) based on having a trisomy?
The article does not say what had been the previous therapy of patients involved in the study, can you provide more details on that.
Did the study sort by therapeutic regimen or only cytogenetic profile?I..while the BEACON article did mention therapy within 90 days of diagnosis..no details of what the therapeutic regimens were, were given.
Does this impact of trisomies only apply to IgH translocations/deletions?
"Based on the current findings, we conclude that the presence of trisomies in patients with t(4;14), t(14;16), t(14;20) or p53 deletion abnormalities in myeloma ameliorates the usual adverse impact associated with these prognostic markers."
Is it only odd numbered trisomies...or can it be any trisomy?
Are there more details that can be provided?
How would you, as a patient weigh this new data?
What kinds of lower dose therapy do you believe could be possible?
What were the therapeutic agents patients were on who demonstrated an ameloriate effect ( longer median OS) based on having a trisomy?
The article does not say what had been the previous therapy of patients involved in the study, can you provide more details on that.
Did the study sort by therapeutic regimen or only cytogenetic profile?I..while the BEACON article did mention therapy within 90 days of diagnosis..no details of what the therapeutic regimens were, were given.
Does this impact of trisomies only apply to IgH translocations/deletions?
-
suzierose - Name: suzierose
- When were you/they diagnosed?: 2 sept 2011
Re: More Good News for High Risk Cytogenetic multiple myelom
Dear Suzierose,
These data are definitely good news for patients who have good-risk features (trisomies) along with high-risk cytogenetic lesions in their myeloma cells. Although your questions are excellent, I am not sure that the study is able to answer all of them. Here goes:
1) The basis by which extra copies of chromosomes (trisomies) imparts a better outcome for myeloma patients is not well understood. It may be due to the increased expression of genes that are present on the affected chromosome (e.g. increased expression of tumor suppressor genes that slow the growth of the disease). Alternatively, the underlying defect in the myeloma cells that allows the development of extra copies of odd-numbered chromosomes may also simply produce inherently less aggressive disease (slower growth, increased sensitivity to myeloma therapy, etc). The investigators only looked at odd-numbered chromosome trisomies, because they are by far more common. It remains to be seen if trisomies of even numbered chromosomes would impart the same improvement in prognosis.
2) The patients in this study were diagnosed between 1/1/2004 and 12/31/2009. 78% of patients received a thalidomide-, lenalidomide-, or bortezomib-based regimen. Since this study came from the Mayo Clinic, I suspect the majority of these patients received a thalidomide- or lenalidomide-based regimen. They do not give the breakdown as to who got what. As such, the study sorted by cytogenetic profile, not by treatment received.
3) Whether these data apply to other high risk features (loss of the short arm of chromosome 1, gains on the long arm of chromosome 1, high risk disease by gene expression profiling) is not known. The investigators only looked at high-rigk IgH translocations (4;14, 14;16, 14;20)
and the p53 deletion (17p deletion or monosomy 17).
4) The important take home point is that the presence of trisomies in patients with high-risk IgH translocations and p53 deletions is associated with a better outcome. The findings of the Mayo group need to be validated in larger studies (there were only 62 patients in the analysis with p53 deletions -- 50% of whom had trisomies). The small sample size precludes the ability to identify more subtle survival differences between the groups. Lastly, it remains to be seen whether this information can be used to guide therapy. For example, does a patient with a 17p deletion and trisomy of chromosome 9 need to be treated with lenalidomide, bortezomib and dexamethasone or just lenalidomide and dexamethasone alone? We should have these answers soon, but not quite yet.
I hope this helps. Take care and have a great weekend!
Pete V.
These data are definitely good news for patients who have good-risk features (trisomies) along with high-risk cytogenetic lesions in their myeloma cells. Although your questions are excellent, I am not sure that the study is able to answer all of them. Here goes:
1) The basis by which extra copies of chromosomes (trisomies) imparts a better outcome for myeloma patients is not well understood. It may be due to the increased expression of genes that are present on the affected chromosome (e.g. increased expression of tumor suppressor genes that slow the growth of the disease). Alternatively, the underlying defect in the myeloma cells that allows the development of extra copies of odd-numbered chromosomes may also simply produce inherently less aggressive disease (slower growth, increased sensitivity to myeloma therapy, etc). The investigators only looked at odd-numbered chromosome trisomies, because they are by far more common. It remains to be seen if trisomies of even numbered chromosomes would impart the same improvement in prognosis.
2) The patients in this study were diagnosed between 1/1/2004 and 12/31/2009. 78% of patients received a thalidomide-, lenalidomide-, or bortezomib-based regimen. Since this study came from the Mayo Clinic, I suspect the majority of these patients received a thalidomide- or lenalidomide-based regimen. They do not give the breakdown as to who got what. As such, the study sorted by cytogenetic profile, not by treatment received.
3) Whether these data apply to other high risk features (loss of the short arm of chromosome 1, gains on the long arm of chromosome 1, high risk disease by gene expression profiling) is not known. The investigators only looked at high-rigk IgH translocations (4;14, 14;16, 14;20)
and the p53 deletion (17p deletion or monosomy 17).
4) The important take home point is that the presence of trisomies in patients with high-risk IgH translocations and p53 deletions is associated with a better outcome. The findings of the Mayo group need to be validated in larger studies (there were only 62 patients in the analysis with p53 deletions -- 50% of whom had trisomies). The small sample size precludes the ability to identify more subtle survival differences between the groups. Lastly, it remains to be seen whether this information can be used to guide therapy. For example, does a patient with a 17p deletion and trisomy of chromosome 9 need to be treated with lenalidomide, bortezomib and dexamethasone or just lenalidomide and dexamethasone alone? We should have these answers soon, but not quite yet.
I hope this helps. Take care and have a great weekend!
Pete V.
-
Dr. Peter Voorhees - Name: Peter Voorhees, M.D.
Beacon Medical Advisor
Re: More Good News for High Risk Cytogenetic multiple myelom
Thank you sooooo much Dr. V!!
Wishing you a blessed week.
Wishing you a blessed week.
-
suzierose - Name: suzierose
- When were you/they diagnosed?: 2 sept 2011
Re: More Good News for High Risk Cytogenetic multiple myelom
My husband has the t 4;14 translocation with trisomies 5 and 19. In the myeloma beacon article, these two odd numbered chromosomes were skipped in the description. Just wondering why and if the good news applies to these odd numbered chromosomes as well. Thank you.
-
Readertk - Name: Tiffany
- Who do you know with myeloma?: husband
- When were you/they diagnosed?: December 2009
- Age at diagnosis: 42
Re: More Good News for High Risk Cytogenetic multiple myelom
Does anyone know if these results also apply to having a tetrasomy? For example, would having four copies of an odd numbered chromosome provide the same advantage as having three copies?
10 posts
• Page 1 of 1