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Defining High-Risk Multiple Myeloma

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Published: Tuesday, Aug 11, 2015


High-risk multiple myeloma is defined by the presence of plasma cell leukemia, elevated levels of lactate dehydrogenase (LDH), or high-risk cytogenetics by FISH analysis, such as 4;14 translocation, 14;16 translocation, 17p deletion, and changes in chromosome 1, explains Morie A. Gertz, MD.

Cells that are sent out for FISH analysis or gene expression profiling are usually from a third aspirate of the bone marrow, which can be very diluted, states Rafael Fonseca, MD. In order to maximize the efficiency of testing, it is important to conduct plasma cell enrichment using cell sorting techniques, notes Fonseca.

Cytogenetic analysis of individuals with rapidly progressing disease and organ damage may not necessarily correlate with other high-risk markers, but these patients still have high-risk disease that requires combination therapy, notes Heather J. Landau, MD. Risk is not only genetic, adds Noopur Raje, MD. Renal failure, bone disease, and other complications need to be treated fairly aggressively, says Raje.
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High-risk multiple myeloma is defined by the presence of plasma cell leukemia, elevated levels of lactate dehydrogenase (LDH), or high-risk cytogenetics by FISH analysis, such as 4;14 translocation, 14;16 translocation, 17p deletion, and changes in chromosome 1, explains Morie A. Gertz, MD.

Cells that are sent out for FISH analysis or gene expression profiling are usually from a third aspirate of the bone marrow, which can be very diluted, states Rafael Fonseca, MD. In order to maximize the efficiency of testing, it is important to conduct plasma cell enrichment using cell sorting techniques, notes Fonseca.

Cytogenetic analysis of individuals with rapidly progressing disease and organ damage may not necessarily correlate with other high-risk markers, but these patients still have high-risk disease that requires combination therapy, notes Heather J. Landau, MD. Risk is not only genetic, adds Noopur Raje, MD. Renal failure, bone disease, and other complications need to be treated fairly aggressively, says Raje.
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