Rajkumar and Kyle list molecular markers used at the Mayo Clinic to identify patients with multiple myeloma with high risk disease. These can help identify patients who may require more aggressive management.
Molecular markers associated with high-risk disease - one or more of the following:
(1) deletion of chromosome 13
(2) hypodiploidy
(3) t(4; 14) on FISH
(4) t(14; 16) on FISH
(5) 17p(-) on FISH
(6) plasma cell labeling index >= 3%
In their experience 25-30% of patients have one or more of these high-risk markers.
The mean survival of a high-risk patient is 2-3 years which is less than half the mean survival seen in low-risk patients.
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