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iwHRMM 2025 | Translocation 4;14 in multiple myeloma: is it truly a marker of high-risk disease?
Mattia D’Agostino, MD, University of Turin, Turin, Italy, discusses the variability in risk among patients with multiple myeloma with translocation 4;14. Dr D’Agostino highlights that identifying which patients are high-risk can be achieved by looking at combinations with other high-risk cytogenetic abnormalities or by examining the site of disruption. This interview took place at the 2nd International Workshop on High-Risk Multiple Myeloma (iwHRMM 2025), held in Charleston, SC.
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Transcript
Translocation 4;14 has been historically considered high risk, but if you look at all patients, you can see that there is a high variability even within translocated 4;14 patients, and you can say that approximately 30 to 40 percent of these patients are truly high risk. How can you identify them? So one way is to look at t(4;14) plus another high-risk cytogenetic abnormalities. One of the most frequent combinations is the combination with 1q copy number alterations...
Translocation 4;14 has been historically considered high risk, but if you look at all patients, you can see that there is a high variability even within translocated 4;14 patients, and you can say that approximately 30 to 40 percent of these patients are truly high risk. How can you identify them? So one way is to look at t(4;14) plus another high-risk cytogenetic abnormalities. One of the most frequent combinations is the combination with 1q copy number alterations. So 1q gain or amplification. So the other thing that can be used to dissect these apparently homogeneous group of patients is to look at the site of disruption of the NSD2 gene. So in the t(4;14) patients, there is a disruption of NSD2, and if this disruption occurs late in the gene, your prognosis is going to be worse.
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