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J Clin Pathol 2008;61:832-836 doi:10.1136/jcp.2007.049585
  • Leading article

Genomic aberrations and immunohistochemical markers as prognostic indicators in multiple myeloma

  1. J Yeung,
  2. H Chang
  1. Laboratory Hematology, University Health Network, Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
  1. Dr Hong Chang, Department of Laboratory Hematology, Toronto General Hospital, University Health Network, 200 Elizabeth Street, 11E-413, Toronto, ON, Canada M5G 2C4; hong.chang{at}uhn.on.ca
  • Accepted 22 November 2007
  • Published Online First 12 December 2007

Abstract

As patients with multiple myeloma (MM) have a variable clinical course, predictive markers would help determine the appropriate treatment strategy. Clinical staging is commonly used to predict outcome, but tumour marker expression and the underlying genetic changes are increasingly used to assess the biological aggressiveness of the disease. Recent studies have demonstrated the utility of immunohistochemistry in detecting prognostic markers, including fibroblast growth factor receptor 3, cyclin D1, c-maf and p53, which have been associated with various genetic aberrations, including t(4;14), t(11;14), t(14;16) and del(17p). While t(4;14), t(14;16) and del (17p) have been documented to confer a poor prognosis, t(11;14) appears to be a neutral or even favourable factor in some studies. CD56, CD33, CD20 and CXCR4 are promising surface markers due to their roles in MM progression, but further studies of larger cohorts are necessary to assess their prognostic relevance. In this review, the biological function and clinical relevance of the main prognostic markers in MM is discussed, and also the role of immunohistochemistry in the stratification of patients into appropriate risk categories.

Footnotes

  • Competing interests: None.

  • Funding: This work is supported by grants from the Leukemia and Lymphoma Research Society of Canada (LLSC), and Cancer Research Society Inc. to HC.

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