# High-risk cytogenetics (myeloma)

Source: https://onco.cc/terms/high-risk-myeloma/  
OnCo record `high-risk-myeloma` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Chromosome changes such as del(17p), t(4;14), t(14;16) and extra copies of 1q that mark myeloma likely to relapse early.

## Summary

IMS 2024 consensus: high risk = del(17p) with TP53 mutation or ≥20% clonal fraction, t(4;14) or t(14;16) or t(14;20) with 1q gain or del(1p), biallelic del(1p32), or β2M ≥5.5 with normal creatinine. Ultra-high risk with two or more lesions. High-risk patients gain less from most regimens; CAR-T and bispecifics narrow but do not close the gap.

## Fields

- Kind: Term
- Last checked: 2026-09-07

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Multiple_myeloma
- Palumbo et al., Revised International Staging System for multiple myeloma: IMWG report (Journal of Clinical Oncology 2015): https://doi.org/10.1200/JCO.2015.61.2267

## Connected records

- cancers: [Multiple myeloma](https://onco.cc/cancers/multiple-myeloma/), [Newly diagnosed multiple myeloma, transplant-eligible](https://onco.cc/cancers/myeloma-transplant-eligible/), [Plasma cell leukaemia](https://onco.cc/cancers/plasma-cell-leukaemia/), [Smouldering multiple myeloma](https://onco.cc/cancers/smouldering-myeloma/)
- targets: [TP53](https://onco.cc/targets/tp53/)
- collections: [Multiple Myeloma Research Foundation (MMRF)](https://onco.cc/collections/mmrf/)
- terms: [t(11;14), cyclin D1 and SOX11](https://onco.cc/terms/cyclin-d1-t11-14/)
- pathways: [Ubiquitin-proteasome system & protein homeostasis](https://onco.cc/pathways/ubiquitin-proteasome-system/)

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