TY - JOUR
T1 - Variability in cytogenetic testing for multiple myeloma
T2 - a comprehensive analysis from across the United States
AU - Yu, Yang
AU - Wade, Niquelle Brown
AU - Hwang, Amie E.
AU - Nooka, Ajay K.
AU - Fiala, Mark A.
AU - Mohrbacher, Ann
AU - Peters, Edward S.
AU - Pawlish, Karen
AU - Bock, Cathryn
AU - van Den, David J.
AU - Rand, Kristin A.
AU - Stram, Daniel
AU - Conti, David V.
AU - Auclair, Daniel
AU - Colditz, Graham A.
AU - Mehta, Jayesh
AU - Haiman, Christopher A.
AU - Terebelo, Howard
AU - Janakiraman, Nalini
AU - Singhal, Seema
AU - Chiu, Brian
AU - Vij, Ravi
AU - Bernal-Mizrachi, Leon
AU - Zonder, Jeffrey A.
AU - Huff, Carol A.
AU - Lonial, Sagar
AU - Orlowski, Robert Z.
AU - Cozen, Wendy
AU - Ailawadhi, Sikander
N1 - Publisher Copyright:
© 2020 by American Society of Clinical Oncology
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Purpose Multiple myeloma (MM) treatment has changed tremendously, with significant improvement in patient out-comes. One group with a suboptimal benefit is patients with high-risk cytogenetics, as tested by conventional karyotyping or fluorescence in situ hybridization (FISH). Methodology for these tests has been published, but not necessarily standardized. Methods We address variability in the testing and reporting methodology for MM cytogenetics in the United States using the ongoing African American Multiple Myeloma Study (AAMMS). We evaluated clinical and cytogenetic data from 1,221 patients (1,161 with conventional karyotyping and 976 with FISH) tested between 1998 and 2016 across 58 laboratories nationwide. Results Interlab and intralab variability was noted for the number of cells analyzed for karyotyping, with a significantly higher number of cells analyzed in patients in whom cytogenetics were normal (P 5.0025). For FISH testing, CD138-positive cell enrichment was used in 29.7% of patients and no enrichment in 50% of patients, whereas the remainder had unknown status. A significantly smaller number of cells was analyzed for patients in which CD138 cell enrichment was used compared with those without such enrichment (median, 50 v 200; P, .0001). A median of 7 loci probes (range, 1-16) were used for FISH testing across all laboratories, with variability in the loci probed even within a given laboratory. Chromosome 13–related abnormalities were the most frequently tested abnormality (n5956; 97.9%), and t(14;16) was the least frequently tested abnormality (n 5 119; 12.2%). Conclusions We report significant variability in cytogenetic testing across the United States for MM, potentially leading to variability in risk stratification, with possible clinical implications and personalized treatment approaches.
AB - Purpose Multiple myeloma (MM) treatment has changed tremendously, with significant improvement in patient out-comes. One group with a suboptimal benefit is patients with high-risk cytogenetics, as tested by conventional karyotyping or fluorescence in situ hybridization (FISH). Methodology for these tests has been published, but not necessarily standardized. Methods We address variability in the testing and reporting methodology for MM cytogenetics in the United States using the ongoing African American Multiple Myeloma Study (AAMMS). We evaluated clinical and cytogenetic data from 1,221 patients (1,161 with conventional karyotyping and 976 with FISH) tested between 1998 and 2016 across 58 laboratories nationwide. Results Interlab and intralab variability was noted for the number of cells analyzed for karyotyping, with a significantly higher number of cells analyzed in patients in whom cytogenetics were normal (P 5.0025). For FISH testing, CD138-positive cell enrichment was used in 29.7% of patients and no enrichment in 50% of patients, whereas the remainder had unknown status. A significantly smaller number of cells was analyzed for patients in which CD138 cell enrichment was used compared with those without such enrichment (median, 50 v 200; P, .0001). A median of 7 loci probes (range, 1-16) were used for FISH testing across all laboratories, with variability in the loci probed even within a given laboratory. Chromosome 13–related abnormalities were the most frequently tested abnormality (n5956; 97.9%), and t(14;16) was the least frequently tested abnormality (n 5 119; 12.2%). Conclusions We report significant variability in cytogenetic testing across the United States for MM, potentially leading to variability in risk stratification, with possible clinical implications and personalized treatment approaches.
UR - http://www.scopus.com/inward/record.url?scp=85092886478&partnerID=8YFLogxK
U2 - 10.1200/JOP.19.00639
DO - 10.1200/JOP.19.00639
M3 - Article
C2 - 32469686
AN - SCOPUS:85092886478
SN - 2688-1527
VL - 16
SP - E1169-E1180
JO - JCO Oncology Practice
JF - JCO Oncology Practice
IS - 10
ER -