Nurses must be aware of cytogenetic testing outcomes and gene-mutation profiles in patients with multiple myeloma (MM), insists a recent study published in the Clinical Journal of Oncology Nursing (CJON).
Cytogenetics is the study of chromosomal abnormalities and their effect on cell behavior. Chromosomal abnormalities in the bone marrow can say quite a bit about the expected course of disease.
Using fluorescence in situ hybridization (FISH), one cytogenic assessment technique, clinicians and laboratory analysts can stratify patients into disease-risk levels.
“Patients with standard risk have the presence of chromosomal abnormalities t(11;14), t(6;14), or hyperdiploidy, whereas those with intermediate risk have the presence of t(4;14), del 13, or hypodiploidy, and those with high risk have the presence of del 17p, t(14;16), or t(14;20),” explains Donna Catamero, ANP-BC, OCN®, CCRC, author of the CJON study.
“Cytogenetic abnormalities in MM influence every aspect of the disease, including progression from [monoclonal gammopathy of undetermined significance], a benign condition, to MM, as well as a patient’s risk of relapse and his or her clinical presentation.”
Bone marrow biopsies can also predict response to treatment.
Because of the frequency of bone marrow biopsy in patients with MM or related disease, nurses should familiarize themselves with gene mutations and other cytogenetic testing results.
“Oncology nurses need to understand the science and meaning of bone marrow biopsy reports,” Donna implores, “including the implications of genetic alterations and minimal residual disease. This will allow them to provide care, support, and education related to MM and its treatment to patients and their families.”