Patients with myeloma having a low RNA index prior to therapy show a number of findings associated with a worse prognosis. The low RNA index may reflect cytogenetic pathways that are associated with reduced RNA synthesis.
Method: flow cytometry, with measurement of > 10,000 cells
Timing: at presentation
RNA index =
= (mean RNA content of tumor G1/0 cells) / (mean RNA content of normal hematopoietic G1/0 cells)
Barlogie et al reported an index < 4 as a low RNA index.
A low RNA index is associated with:
(1) poor response to some chemotherapeutic agents
(2) shorter time to relapse
(3) reduced survival
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