Patients with myeloma having DNA hypoploidy have poor response to standard chemotherapy and an overall poor prognosis. A patient with high risk features may benefit from more aggressive or novel therapies.


Method: flow cytometry with propidium iodide (PI) staining


DNA content of plasma cells can be classified as:

(1) diploid

(2) hyperdiploid

(3) hypodiploid


Correlations with hypodiploidy:

(1) poor response to chemotherapy

(2) poor overall survival (according to Morgan et al: 2.5 months versus 24 months for diploid or hyperdiploid)

(3) irregular nuclear shape of bone marrow plasma cells


Additional risk factors for poor prognosis:

(1) deletion of chromosome 13

(2) myelodysplastic-type cytogenetic abnormalities

(3) deletion of p53 by FISH (chromosome 17)

(4) c-myc (chromosome 8)

(5) t(4;14) or t(14;16) involving immunoglobulin heavy chain (IgH) gene at 14q32


A patient with high risk features is less likely to benefit from high-dose chemotherapy with autologous stem cell transplant.


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