LAUSR

Introduction MM is a clonal disorder of malignant plasma cells. Standard of care for newly diagnosed MM is induction with triplet regimen chemotherapy followed by ASCT. Patients are stratified based on cytogenetic analysis as being high risk and standard risk. t(11;14) comprises ∼ 15-20% of newly diagnosed MM, making it the most common translocation. t(11;14) has been classified as standard risk. However, it is now increasingly being considered as intermediate risk, conferring inferior outcome compared with standard-risk MM.(Walker, Wardell et al. 2012) Methods We performed a retrospective analysis of 806 pts with newly diagnosed MM who underwent ASCT at our institution. Pts were stratified as high risk in the presence of t(4;14), t(14;16), gain 1q or del17p.by FISH. PFS and OS rates were estimated using Kaplan-Meier method. Log-rank tests were used to compare the PFS and OS between the two groups. The Cox proportional hazard models were used to estimate the hazard ratios (HR). Results Among 806 patients, 156 pts (19.4%) were positive for t(11;14). 81.5% of pts were 65 yrs or younger, and 59% were males. There were no significant differences in pt characteristics (see table) Median PFS from ASCT in pts with t(11;14) was 3.0 yrs (95% CI: 2.3-4.3) vs. 3.3 yrs (95% CI: 2.8-3.8) in those without t(11;14)[HR=1.03, 95% CI: 0.82-1.29, p=0.81. There was no statistical difference in OS from ASCT [HR of 0.97 (95% CI: 0.70-1.33, p 0.84)]. 5 yr PFS rate was 37% for pts with t(11;14) & 53% in pts without. 5 yr OS rate was 65% for pts with t(11;14) & 66% for those without. Conclusion t(11;14) is a common cytogenetic abnormality in MM. According to our analysis, there is no significant difference in outcomes following ASCT in both high risk and standard risk subgroups. t(11;14) MM is predicted to be BCL-2 dependent and the use of BCL-2 inhibitors in induction or post-ASCT maintenance is an attractive option to improve outcomes.