The definition of high-risk disease continues to evolve based on available evidence. To risk-stratify myeloma patients at initial diagnosis we perform fluorescence in situ hybridization (FISH) studies on the bone marrow for t(11;14), t(4;14), t(6;14), t(14;16), t(14;20), del17p13, gain 1q, and trisomies of odd numbered chromosomes.
LDH: lactate dehydrogenase. * Defined by either ≥2000 plasma cells/microL of peripheral blood, or ≥20% on a manual differential count. ¶ While patients with a high-risk signature on gene expression profiling are considered to have high-risk myeloma, this test is not recommended on a routine basis.
