Del(17p) Without TP53 Mutation Confers A Poor Prognosis In Intensively Treated Newly Diagnosed Patients With Multiple Myeloma
In an abstract published in the Journal Blood, March 4, 2021, investigators report on “double hit” multiple myeloma prognostication. TP53 mutations as well as 17p deletions are well-known poor prognostic variables in multiple myeloma. Little data had been published on the prognostic value of these independently or in combination. After a sentinel study had shown that a combination of a 17p deletion and a TP53 mutation also known as a “double hit”, has far worse prognostication investigators wanted to report on further larger cohort of patients.
A study including 121 patients presenting with 17p deletions and more than 55% of the plasma cells with relatively homogeneous intensive therapy treatment exposure were reported on. Deep next generation sequencing targeting the TP53 mutation was performed. The outcomes were compared against large control groups of patients, including 2,505 patients with 17p deletions. The authors stated that the results confirmed that the double hit situation is the worst. They report a median survival of 36 months. The 17p deletion alone confers a worse outcome compared to the control cohort, with a median survival of 52.8 months versus 152.2 months, respectively.
The authors concluded “in conclusion, our study clearly confirms the extremely poor outcome of patients displaying double hit but also that the 17p deletion alone is still a very high risk feature, confirming its value as a prognostic indicator for poor outcome”.