Distinct Clinical Features of Multiple Myeloma With t(11;14): A Post Hoc Analysis of JSH ‐ MM ‐15 Study

t(11;14) (q13;q32) occurs in approximately 15%-25% of multiple myeloma (MM) cases and has traditionally been regarded as a standard cytogenetic risk factor. However, recent evidence suggests that MM with t(11;14) exhibits heterogeneous biological characteristics and clinical outcomes distinct from those associated with other cytogenetic risk categories. In a post hoc analysis of the prospective JSH-MM-15 study, we investigated the prognosis of newly diagnosed MM patients to identify prognostic features unique to t(11;14)-positive cases and to evaluate treatment factors influencing outcomes. Among 482 patients evaluated for t(11;14), 131 (27%) were positive. Overall survival (OS) in t(11;14)-positive patients was intermediate between standard- and high-risk groups, whereas progression-free survival (PFS) was comparable to that of high-risk cases. Deep response rates, including ≥ complete response (CR)/stringent CR and ≥ very good partial response, were lower in t(11;14)-positive MM than in other risk groups, and these responses were not associated with survival in t(11;14)-positive cases, in contrast to t(11;14)-negative MM. Compared with t(11;14)-negative MM, t(11;14)-positive patients more frequently expressed CD20 and less frequently expressed CD56 on myeloma cells. Exploratory analyses showed that, despite higher ≥ CR rates, OS was worse in patients with CD20-negative/CD56-negative tumors among t(11;14)-positive MM. Among CD20-positive patients, PI-containing regimens were associated with better OS, although no significant PFS benefit was observed. These findings support the biological and clinical heterogeneity of t(11;14)-positive MM and highlight the need for prospective validation of subgroup-specific treatment outcomes.

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Journal
Cancer Science
Published
2026-10-15
DOI
https://doi.org/10.1111/cas.70564
Primary Topic
Multiple Myeloma Research and Treatments
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article
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article

Distinct Clinical Features of Multiple Myeloma With t(11;14): A Post Hoc Analysis of JSH ‐ MM ‐15 Study

Shin‐ichi Fuchida, Hitoshi Kiyoi, Haruya Okamoto, Isamu Sugiura et al.
Cancer Science
Multiple Myeloma Research and Treatments
article

Distinct Clinical Features of Multiple Myeloma With t(11;14): A Post Hoc Analysis of JSH ‐ MM ‐15 Study

Shin‐ichi Fuchida, Hitoshi Kiyoi, Haruya Okamoto, Isamu Sugiura, Satoru Kosugi, Yuji Shimura, Akifumi Takaori‐Kondo, Hiroshi Handa, Junya Kuroda, Shinsuke Mizutani, Itaru Matsumura, Shuichi Ota, K Akashi, Hirohiko Shibayama, Taku Tsukamoto, Makoto Yoshimitsu, Tadao Ishida, Shinsuke Iida, Yutaka Shimazu, Takahiro Fujino, Mitsuhiro Itagaki, Akiko Moriya Saito, Morio Sawamura, Takayuki Shimizu, Hiroyuki Takamatsu
article en

Abstract

t(11;14) (q13;q32) occurs in approximately 15%-25% of multiple myeloma (MM) cases and has traditionally been regarded as a standard cytogenetic risk factor. However, recent evidence suggests that MM with t(11;14) exhibits heterogeneous biological characteristics and clinical outcomes distinct from those associated with other cytogenetic risk categories. In a post hoc analysis of the prospective JSH-MM-15 study, we investigated the prognosis of newly diagnosed MM patients to identify prognostic features unique to t(11;14)-positive cases and to evaluate treatment factors influencing outcomes. Among 482 patients evaluated for t(11;14), 131 (27%) were positive. Overall survival (OS) in t(11;14)-positive patients was intermediate between standard- and high-risk groups, whereas progression-free survival (PFS) was comparable to that of high-risk cases. Deep response rates, including ≥ complete response (CR)/stringent CR and ≥ very good partial response, were lower in t(11;14)-positive MM than in other risk groups, and these responses were not associated with survival in t(11;14)-positive cases, in contrast to t(11;14)-negative MM. Compared with t(11;14)-negative MM, t(11;14)-positive patients more frequently expressed CD20 and less frequently expressed CD56 on myeloma cells. Exploratory analyses showed that, despite higher ≥ CR rates, OS was worse in patients with CD20-negative/CD56-negative tumors among t(11;14)-positive MM. Among CD20-positive patients, PI-containing regimens were associated with better OS, although no significant PFS benefit was observed. These findings support the biological and clinical heterogeneity of t(11;14)-positive MM and highlight the need for prospective validation of subgroup-specific treatment outcomes.

Cancer Science
Kanazawa University (JP), Kagoshima University (JP), Kyushu University (JP), Gunma University (JP), Kyoto University (JP), Nagoya City University (JP), Kyoto Prefectural University of Medicine (JP), Toyonaka Municipal Hospital (JP), Osaka National Hospital (JP), Tokyo Medical Center (JP), Japanese Red Cross Medical Center (JP), Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital (JP), Sapporo Hokuyu Hospital (JP), National Hospital Organization (JP), Toyohashi Municipal Hospital (JP), Nagoya Medical Center (JP), Tokyo National Hospital (JP), Kyoto Kuramaguchi Medical Center (JP), National Hospital Organization Shibukawa Medical Center (JP), Nagoya University (JP), Kindai University (JP)
Openalex Percentile: Top 12%
Multiple Myeloma Research and Treatments
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