The Prognostic Significance of Chromosomal Abnormalities in Iraqi Myeloma Patients

Abstract

Background: Multiple myeloma, a cancer derived from plasma cells, accounts for 0.9% of global cancer cases, predominantly in developed countries. It leads to severe health complications including skeletal damage, renal failure, anemia, and increased infection risk. High-risk cytogenetic abnormalities like t(4;14), t(14;16), del(17p), and non-hyperdiploid karyotypes correlate with poor prognosis, necessitating cytogenetic evaluations in all newly diagnosed cases to direct treatment.

Aim: To assess the incidence, frequency, and impact of certain genomic abnormalities in a clinical course of newly diagnosed myeloma patient.

Methods: A cohort study, both retrospective and prospective, was performed on 60 diagnosed patients at Baghdad Medical City from October 2020 to June 2022. Data collected included demographics, comorbidities, bone marrow analysis, immunophenotyping by flow cytometry, cytogenetic studies via FISH, and blood tests. Treatment responses and survival rates were evaluated.

Results: The average age was 59.93 ± 11.15 years, with standard risk cytogenetics most prevalent. The VRD protocol was used in 60% of cases. The complete response rate was 36.7%, with an overall response rate of 68.3%. Patients with high-risk cytogenetics showed lower progression-free survival compared to those with normal or standard risk (p=0.017), although overall survival did not significantly differ among the groups (p=0.64).

Conclusion: Our research demonstrates that while the incidence of high-risk cytogenetics is slightly lower than global averages, such genetic risk factors significantly shorten progression-free survival. However, no notable difference was observed in overall survival among different cytogenetic risk groups.