Impact of Chromosomal Aberrations Detected by Chromosome Banding Analysis in Symptomatic Waldenström’s Macroglobulinemia

Abstract

Background The clinicopathologic features and prognostic impact of MYD88 L265P (MYD^L265P) and CXCR4 mutations (CXCR4^Mut) have been well reported, although little is known regarding the impact of chromosomal aberrations (CA) detected by chromosome banding analysis (CBA) in symptomatic Waldenström’s macroglobulinemia (sWM). Thus, we investigated the clinicopathologic features and prognostic impact in sWM with CAs identified by CBA. Methods We retrospectively analyzed the clinicopathologic results and genetic mutations by droplet digital PCR, fluorescence in situ hybridization (FISH), and CBA using the G-banding method from the bone marrow samples of sWM between April 2010 and March 2024 at our institute. The relationship between CAs and clinicopathologic features was evaluated, as well as the time to next treatment (TTNT). Results Thirty-five patients were enrolled. The median age was 71 years, and the median hemoglobin level was 10.1 g/dL. The median serum IgM and M-protein levels were 3,120 mg/dL and 3 g/dL, respectively. MYD^L265P was found in 30/35 patients (85.7%), whereas CXCR4^Mut was found in 3/35 patients (8.6%). Deletion 6q identified by FISH in 5/18 patients (28%), and CAs using CBA in 9/34 patients (26%), including 4/34 (12%) complex karyotypes. sWM with CAs had more anemia (p = 0.04) and hypoalbuminemia (p = 0.007), in addition to higher serum M-protein and IgM levels (p = 0.03). With a median follow-up of 73 months, the median TTNT in patients with and without CAs was 27 and 68 months, respectively. Conclusions CAs with CBA may be associated with clinical aggressiveness and shorter TTNT in sWM.