A 55-year-old woman with multiple myeloma is found to have deletion of chromosome 17p on FISH. This deletion most likely involves which gene and confers what prognostic significance?

• A RB1 deletion — poor prognosis
• B TP53 deletion — poor prognosis ✓
• C CDKN2A deletion — intermediate prognosis
• D NF1 deletion — favorable prognosis

Explanation

Deletion of 17p13.1, which harbors TP53, is one of the highest-risk cytogenetic abnormalities in multiple myeloma, associated with shorter progression-free survival and overall survival, and is classified as high-risk cytogenetics by the IMWG. Del(17p) correlates with resistance to conventional therapy and requires aggressive treatment approaches. RB1 loss at 13q is common but less prognostically dire than 17p. CDKN2A and NF1 deletions are not the primary lesion on 17p.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.