A 70-year-old man with multiple myeloma has del(17p13.1) detected by FISH. This deletion involves the TP53 locus and carries which prognostic significance?
- A High-risk myeloma associated with inferior outcomes even with novel agent-based therapy ✓
- B Standard-risk myeloma with excellent response to bortezomib
- C Indicates smoldering myeloma that does not require treatment
- D Favorable cytogenetics comparable to hyperdiploidy
Correct answer: A. High-risk myeloma associated with inferior outcomes even with novel agent-based therapy
Explanation
Deletion of 17p13.1 (TP53 locus) is classified as high-risk cytogenetics in multiple myeloma by the Revised International Staging System (R-ISS) and is associated with shorter progression-free and overall survival even with bortezomib-based or lenalidomide-based regimens. Other high-risk FISH findings include t(4;14), t(14;16), and gain(1q). Hyperdiploidy (odd-numbered chromosomal gains) is favorable.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.