Linda B. Baughn

@theMMRF @MMRFTeam4Cures An incredible experience. 30 miles of hiking with new friends. The best part: the team raised $75K for MM research! So grateful for the opportunity @GD_251

Thrilled about this collaborative project evaluating venetoclax response in the myeloma subtype I’m so curious about-t(11;14). Grateful to all of the collaborators included here.

@mehndz @RahulBanerjeeMD @VincentRK @OncBrothers @BijoyTelivala @rajshekharucms @Myeloma_Doc 20% is the technical cutoff- determined by the lab. If result is < 20%, you can’t say a result is “positive”. <20% is within the “normal range” because by FISH you can random lost, gained, overlapped signals etc similar to other assays. Assay “noise.”

@RahulBanerjeeMD @VincentRK @OncBrothers @BijoyTelivala @rajshekharucms @Myeloma_Doc @lbaughn I was about to say the same thing, this is gain of 17. It is so difficult to Interpret these reports and then they have a cut of value towards it of 20%; what does that even imply? 😮

@VincentRK @OncBrothers @rajshekharucms 75 M-recurrent ITP with plt going down to10. Has needed Dex/R (last dose6 mths ago) Light chain ratio 10. Small M spike- stablish for 5-6 yrs BM Bx 5-10 % plasma cells FISH p53+ Pet neg I was going to observe , but i am worried about p53

@RahulBanerjeeMD @VincentRK @OncBrothers @BijoyTelivala @rajshekharucms @Myeloma_Doc Good call Rahul. Agree likely trisomy 17. Curious if case is hyperdiploid with a possible trisomy 11 and 17 since they found gain of TP53 and CCND1. NOT tp53 del.

@VincentRK @OncBrothers @BijoyTelivala @rajshekharucms @Myeloma_Doc Agreed with Vincent – I’ll also add that the FISH report is the phenomenon that @lbaughn and others have been working on fixing – clearly work left to be done. That report shows trisomy 17 instead of del(17p), and it’s so hard for anyone to notice unless you really look!

Standardizing FISH testing in myeloma is critical to reduce lab to lab variability and misinterpretation. We propose guidelines for FISH panel design and reporting to align with the new IMS/IMWG risk stratification. @CG_Consortium @MayoMyeloma

@RenoHemonc @AuclairDan Commercial labs like Mayo will be reporting mono and biallelic 1p. This information would also be in the cytogenetics nomenclature in commercial lab reports. Mono del=x1, biallelic del=x0

@AuclairDan Are commercial labs like Neo reporting mono vs biallelic?

Important paper. Note slight tweaks since it was first presented last year #mmsm

We will also be providing recommendations to other labs on how to perform and interpret to meet the IMS/IMWG definition with a publication led by @lbaughn in @BloodCancerJnl shortly. Stay tuned.

We’re hiring! Postdoc in Computational Genomics at @EdinUni_IGC Focus: myeloma genome, structural variants, heterochromatin, multiomics Deadline: 9 July 2025, 23:59 GMT Apply here: elxw.fa.em3.oraclecloud.com/hcmUI/Candidat… #myeloma #postdoc #genomics #bioinformatics #epigenetics #codeandkilts

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A recently published paper supports the reporting of these unbalanced MYC-R as positive. Nice to see additional support for unbalanced MYC-R as being real abnormalities sciencedirect.com/science/articl…

We propose interpreting unbalanced MYC-r by FISH in HGBCL as “likely positive”. I hope future testing will incorporate WGS and/or RNA seq.

FISH testing for MYC is part of routine clinical evaluation for high grade B-cell lymphomas. We showed a high false negative rate for the MYC break apart FISH probe (4%) or the MYC/IGH probe (22%). Thus, FISH will not detect all MYC rearrangements in B-cell lymphomas.

@RahulBanerjeeMD @bbehin Agree on del 17p. I would also suggest other high risk abnormalities like 1p del, 1q gain or amplification. If enough sample exists IGH break apart. If abnormal, t(4;14).

It’s an excellent question! I’ll defer to @lbaughn for a more nuanced answer, since I actually don’t know how carefully this has been addressed. I’d suggest del(17p) as the most important test to triage, but I’m not sure if a consensus exists here - if not, we should make one!

The future of FISH reporting in #MMsm is almost here thanks to great work by @lbaughn and the consensus panel she has assembled for this important topic!

The MMRF Immune Atlas team describes immune cells & clinical outcomes in myeloma. Emory, Beth Israel, WUSTL, MSSM, Mayo & MMRF profiled >1.1 million marrow cells from CoMMpass patients. Preprint at biorxiv.org/content/10.110… has details. #myeloma

@RahulBanerjeeMD @adamssperling @alex_epi_tria *interpret

@RahulBanerjeeMD @adamssperling @alex_epi_tria One question is how to intercept a “relative TP53 loss” (2 copies of TP53) in the context of a trisomy 17. Is this worse than 3 copies of TP53?

In contrast, shout out to Neogenomics for this EXCELLENT myeloma #MMsm FISH report 👏 3 copies of the probes on 17p and 17q? Throw in a “trisomy 17” into the report and clearly say that del(17p) was not detected. Hopefully this type of report will become the norm!

@MyelomaAmateur @RahulBanerjeeMD @alex_epi_tria Some trisomies can be present from birth like trisomy 21. In this context however, these trisomies are acquired in the MM clone. Great questions Kate.

@RahulBanerjeeMD @alex_epi_tria @lbaughn Are these trisomies acquired or present from birth?

@RahulBanerjeeMD @alex_epi_tria Many labs use a probe for TP53 as well as the centromere of 17 (the middle section of the chromosome between the p and q arms).

@alex_epi_tria @lbaughn I don’t think it’s reliably checked for, since technically it would require a probe for both 17p and 17q to prove it? @lbaughn will know better than me… but it may very well be worth it to start checking more!

We are eager to hear from the community clinicians!

@PedalheadPHX @JanakiramMurali @ACCCBuzz I agree with this observation. Do clinicians want this information in a FISH report? Providing not just diagnostic or prognostic information, but information about therapeutic value?

We have to reach physicians in the community to see how we can get their input. Can @ACCCBuzz help to get this survey out and partnering with them. Apart from risk stratification, can we report that BCL2 inhibitors can be used in the FISH report. @PedalheadPHX @lbaughn

@PedalheadPHX @RahulBanerjeeMD clinical-lymphoma-myeloma-leukemia.com/article/S2152-…

@PedalheadPHX @RahulBanerjeeMD Yikes! Assume there was gain of CCND1 without IGH fusion. If it is an isolated gain seen by FISH, sometimes we do a CCND1 break apart to rule out a CCND1 rearrangement like IGL or IGK::CCND1. Rare though.

Thank you to those who have completed the myeloma FISH survey! We are so grateful. If you haven’t yet completed the survey, we ask you to please consider making your voice heard. Your responses are so valuable. #MMSM @RahulBanerjeeMD