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ORIGINAL RESEARCH article
Front. Med.
Sec. Hematology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1536825
This article is part of the Research Topic Infectious Diseases and Hematology: Diagnosis and Management - Volume II View all 9 articles
De novo abnormalities identified by fluorescence in situ hybridization during follow up confer poor prognosis in Chinese multiple myeloma
Provisionally accepted
Shumin Chen 
Yueyun Lai * Lu Gao Lin Feng Zheng Wang 
Li Ye Qing Liu Wenjie Song Shu Kong Yang Liu Jin Lu Xiaojun Huang 
Ying-Jun Chang - Peking University People's Hospital, Beijing, China
Abstract: Background: Although there is evolving consensus to re-evaluate cytogenetic features during follow-up in multiple myeloma (MM), longitudinal studies on cytogenetic evolution in Chinese MM patients are still lacking. Our aim was to highlight the importance of ongoing monitoring of cytogenetic characteristics and shed light on the implications of clonal evolution in Chinese MM patients. Patients and methods: The clinical data of 230 MM patients were retrospectively analyzed, including 100 patients were continuously monitored for cytogenetic abnormalities by fluorescence in situ hybridization (FISH). Results: 49 out of 100 patients acquired de novo FISH abnormalities during follow-up, which were associated with disease progression (P=0.003) and inferior progression free survival (PFS) (median 31 vs 51 months, P = 0.032). Patients with ≥ 2 de novo FISH abnormalities had poorer PFS (median 24 vs 45 months, P =0.003) when compared to those with l or no de novo FISH abnormality. Patients who acquired new abnormalities within 31 months since diagnosis had significantly worse PFS (median: 20 months vs 41 months, p < 0.001) and OS (median: 61 months vs 100 months, p = 0.008) compared to those who acquired new abnormalities after 31 months. When gain/amp 1q21, del(17p), t(4;14), and t(14;16) were classified as high risk abnormalities (HRA), patients with ≥2 HRA had a shorter PFS (median 28 vs 49 months, P =0.038) and OS (median 75 vs 107 months, P =0.040) when compared to those without HRA. Conclusion: Re-evaluation of cytogenetic characteristics by serial FISH tests is important in MM patients. De novo FISH abnormalities during follow-up are adverse prognostic factors, especially when ≥ 2 new FISH anomalies and acquired new abnormalities within 31 months since diagnosis are presented, and the presence of ≥ 2 HRA during the disease process are associated with poor survival in Chinese MM patients.
Keywords: Multiple Myeloma, Survival, high-risk, Clonal Evolution, Cytogenetics
Received: 29 Nov 2024; Accepted: 17 Feb 2025.
Copyright: © 2025 Chen, Lai, Gao, Feng, Wang, Ye, Liu, Song, Kong, Liu, Lu, Huang and Chang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yueyun Lai, Peking University People's Hospital, Beijing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.