Multiple myeloma and t(11;14): prognostic significance and impact of novel agents on response and survival.

Abstract Multiple myeloma (MM) patients with t(11;14) present unique biological features and their prognosis is not well established. We report a retrospective study of 591 MM patients, 17.6% of whom had t(11;14). It was designed to determine the prognostic impact of this abnormality and the effect of novel agents on the response and outcomes. Three groups were established based on their cytogenetics: 1) t(11;14); 2) high-risk chromosomal abnormalities; and 3) standard risk (SR). After 80.1 months (1.2-273.8 months) of follow-up, no differences were observed in overall survival (OS) between the t(11;14) and SR groups (75.8 vs. 87.2 months; P = 0.438). However, in ISS-1 stage patients, MM t(11;14) individuals had shorter OS than those in the SR group (62.9 vs. 126.7 months; P = 0.004). Treatment of MM t(11;14) with novel agents did not improve their overall response rate (ORR) or complete response (CR) compared with those who received conventional therapy (ORR: 87.2% vs. 79.5%, P = 0.336; CR: 23.4% vs. 12.8%, P = 0.215). This effect translated into similar PFS (39.6 vs. 30.0 months; P = 0.450) and OS (107.6 vs. 75.7 months; P = 0.175). In summary, MM t(11;14) patients did not benefit from the introduction of novel agents as much as SR patients did, indicating that other therapies are needed if their outcome is to be improved.