P-245: Taking a peek into the cytogenetic profile of an Indian cohort.

Introduction: Multiple myeloma is a genetically heterogeneous disease with varied presentations. Besides patients' related factors and treatment used, biological characteristics of malignant plasma cells determine outcomes and cytogenetics is part of currently used risk stratification models. This study focuses on the cytogenetic patterns and their relations to the presentation, prognosis and outcomes in multiple myeloma. This study also aims to compare the old IWMG classification of high risk stratification to the 2024 IMS consensus recommendations.

Methods: We have used electronic medical records from a tertiary health care hospital in India to collect data. FISH analysis was performed on sorted BM plasma cells. Data pertaining to 221 patients was entered systematically into an excel sheet out of which 178 had reports available to cytogenetic testing. Retrospective analysis was conducted using Chi-square to find significant associations, univariate and multivariate analysis were further done on these findings.

Results: Incidence of cytogenetic patterns in our study were as follows: 13(7.3%) patients showed t(4:14), 5(2.8%) had t(14:16), 5(2.8%) had 17p deletion, 29(16.4%) with 1q-gain, 21(11.9%) with 1q-amplification, 7(4%) with 1p deletion, IgH translocation to unknown partner was seen in 37(20.9%) patients, 7(4%) had t(11:14), 4(2.3%) had t(6:14), 62(35.07%) with deletion 13/monosomy, 90(50.8%) had hyperdiploidy, 21(11.9%) had high risk cytogenetics (t(4:14), t(14:16) and/or del17P). Double hit and triple hit were noted in 10 patients (5.6%) and 1 (0.56%) patients respectively. High risk cytogenetics markers were associated with hypoalbuminemia at presentation (p< 0.001), extramedullary and paramedullary disease (p=0.01), serological progression (p< 0.001), death (p=0.011). According to the new high risk stratification 21 patients out of 178 were high risk (11.79%) and predicted early mortality (p=0.006) and hypoalbuminemia at presentation(p=0.008). There was no difference between the overall response rates (66.7% Vs 68% of VGPR or better ) of high risk patients according to either old or new high risk stratification systems. t(4:14) was associated with paramedullary disease (p< 0.001) and with serological progression after initial therapy (p< 0.001).

Conclusions: This study suggests the lower incidence of some of recurring cytogenetic abnormalities in our patient cohort possibly due to prior treatment and a better diagnostic modalities should be evalauted.