Genomics

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Molecular prognosis in multiple myeloma


ABSTRACT: Purpose Survival of patients with multiple myeloma is highly heterogeneous from periods of few weeks to more than ten years. We used gene-expression profiles of myeloma cells obtained at diagnosis to identify broadly applicable prognostic markers. Methods In a training set of 182 patients, we used supervised methods to identify individual genes associated with length of survival. A survival model was built from these genes. The validity of our model was assessed in our test set of 68 patients and in three independent cohorts comprising 853 multiple myeloma patients. Results The 15 strongest genes associated with the length of survival were used to calculate a risk score and to stratify patients in low-risk and high-risk. The survival-predictor score was significantly associated with survival in both the training and test sets and in the external validation cohorts. The Kaplan Meier estimates of rates of survival at 3 years were 90.5 percent (95 percent CI, 85.6 – 95.3), and 47.4 (95 percent CI, 33.5 - 60.1) respectively in our patients having a low-risk or high-risk, independently of traditional prognostic factors. High-risk patients constituted a homogeneous biological entity characterized by the overexpression of genes involved in cell cycle progression and its surveillance, while low-risk patients were heterogeneous and displayed hyperdiploid signatures. Conclusion Gene expression-based survival prediction and molecular features associated with high-risk patients may be useful for developing prognostic markers and may provide basis to treat these patients with new targeted anti-mitotics. Keywords: Gene-expression profiling

ORGANISM(S): Homo sapiens

PROVIDER: GSE7039 | GEO | 2008/08/05

SECONDARY ACCESSION(S): PRJNA98499

REPOSITORIES: GEO

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