Cytogenetic patterns in multiple myeloma after a phase of preceding MGUS

Background Presenting the same histological diagnosis, multiple myeloma (MM) shows a large genomic variety, resulting in variable times of overall survival. Materials and methods To investigate major cytogenetic categories (any 14q‐translocation, t(11;14), t(4;14), 13q‐deletions, 17p‐deletions) and their clinical consequences in MM after a pre‐existing monoclonal gammopathy (MM post‐MGUS), we performed a comparative analysis of 41 patients with MM post‐MGUS and 287 patients with unknown prior history MM (U‐MM). Results In MM post‐MGUS, a t(11;14) was found to be more frequent than in U‐MM (24% vs. 14%) and it was associated with significantly shortened survival (24 months vs. 70 months in U‐MM; P = 0·01). MM post‐MGUS was further characterized by a higher frequency of 13q‐deletions only (absence of all other specific abnormalities; 28% vs. 12% in U‐MM; P = 0·02). A 13q‐deletion only was an indicator of long survival in MM post‐MGUS (median not yet reached) as opposed to U‐MM (median survival, 29 months; P = 0·001). 17p‐deletions were infrequent in MM post‐MGUS (3% vs. 16% in U‐MM; P = 0·04). Survival times for patients with t(4;14) and/or 17p‐deletions and other abnormalities were similar in both MM patient cohorts. Conclusions Our data suggest that t(11;14) and 13q‐deletions have distinct prognostic implications in the context of MM post‐MGUS.