Haematologica (Mar 2009)

Translocation t(11;14) and survival of patients with light chain (AL) amyloidosis

  • Alan H. Bryce,
  • Rhett P. Ketterling,
  • Morie A. Gertz,
  • Martha Lacy,
  • Ryan A. Knudson,
  • Steven Zeldenrust,
  • Shaji Kumar,
  • Suzanne Hayman,
  • Francis Buadi,
  • Robert A. Kyle,
  • Philip R. Greipp,
  • John A. Lust,
  • Stephen Russell,
  • S. Vincent Rajkumar,
  • Rafael Fonseca,
  • Angela Dispenzieri

DOI
https://doi.org/10.3324/haematol.13369
Journal volume & issue
Vol. 94, no. 3

Abstract

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Background Light chain amyloidosis is a rare plasma cell dyscrasia. Interphase fluorescence in situ hybridization (FISH) coupled to cytoplasmic staining of specific Ig (cIg-FISH) on bone marrow plasma cells has become well established in the initial evaluation of multiple myeloma, a related disorder. Little, however, is known about cytogenetic abnormalities in patients with light chain amyloidosis.Design and Methods We reviewed 56 patients with light chain amyloidosis who had cIg-FISH performed as part of their routine clinical testing using the standard screening panel employed in multiple myeloma at our institution.Results Seventy percent of patients had abnormal cIg-FISH, with the most common abnormalities being IgH translocations [48%] – including t(11;14) [39%], and t(14;16) [2%] – and del13/del13q [30%]. No t(4;14) or deletions of 17p (p53) were observed. Patients with t(11;14) had the lowest levels of clonal plasma cells, and those with del13 had the highest. The risk of death for patients harboring the t(11;14) translocation was 2.1 (CI 1.04–6.4), which on multivariate analysis was independent of therapy.Conclusions Although preliminary, our data would suggest that cIg-FISH testing is important in patients with light chain amyloidosis and that t(11;14) is an adverse prognostic factor in these patients.