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    Myeloma Genomics and Microenvironment and immune profiling

    Category: Myeloma Genomics and Microenvironment and immune profiling

    Monosomy 13 and Deletion of 13q Predict Inferior Outcomes in Multiple Myeloma Patients Undergoing Upfront Autologous Transplant

    (PA-266) Monosomy 13 and Deletion of 13q Predict Inferior Outcomes in Multiple Myeloma Patients Undergoing Upfront Autologous Transplant

    Friday, September 19, 2025
    • OP

      Oren Pasvolsky, MD

      Assistant Professor
      Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center

    Introduction: Monosomy 13/deletion(13q) is a common cytogenetic abnormality in multiple myeloma (MM). Although often associated with other high-risk cytogenetic abnormalities (HRCA), its independent prognostic significance remains unclear.

    Methods: We conducted a retrospective, single-center chart review of MM patients who underwent autologous hematopoietic stem cell transplantation (autoHCT) between 2010 and 2021 at our institution with available fluorescence in situ hybridization (FISH) results. HRCA were defined as del(17p), t(4;14), t(14;16), t(14;20), gain/amplification of 1q and del(1p).

    Results:

    A total of 1,680 patients were included, with monosomy 13/del(13q) identified in 591 cases (35.1%). Monosomy 13 was more common (428, 25.5%) than del(13q) (162, 9.6%).

    Compared to patients without HRCA or monosomy 13/del(13q) (reference group), those with isolated monosomy 13/del(13q) (n=77) had significantly shorter progression-free survival (PFS; median 37.3 months vs. 64.6 months, p=0.0002) and overall survival (OS; median 105.4 months vs. 131.0 months, p=0.0171). A similar adverse prognostic effect was observed in patients with monosomy 13/del(13q) co-occurring with non-HRCA (n=162) (median PFS 39.4 months, p < 0.0001; median OS 91.1 months, p=0.0003).

    Co-occurrence of HRCA with monosomy 13/del(13q) (n=352) was associated with shorter PFS (33.9 vs. 48.9 months, p=0.0020) and OS (81.6 vs. 98.3 months, p=0.0005) compared to HRCA alone. In subgroup analyses, monosomy 13/del(13q) was associated with inferior PFS in patients with specific HRCAs, including t(4;14), del(17p), and del(1p), but not with gain/amplification of 1q.

    Finally, multivariate Cox regression analyses confirmed that monosomy 13/del(13q), whether isolated or co-occurring with non-HRCA, was independently associated with inferior PFS (HR 1.36, 95%CI: 1.17–1.58, p=0.0001) and OS (HR 1.49, 95%CI: 1.21–1.84, p=0.0002).

    Conclusions: In this large cohort of MM patients who received upfront autoHCT, monosomy 13/del(13q) was an independent adverse prognostic factor, associated with inferior PFS and OS. Its negative impact was evident both in isolation and with concomitant non-HRCA, and was further exacerbated when co-occurring with HRCA, indicating an additive detrimental effect.