t(11;14)(q13;q32) IGH/CCND1 translocation in multiple myeloma — ~15-20% prevalence, BCL-2...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-MM-T11-14-ACTIONABLE`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	`DIS-MM`
Sources	`SRC-EHA-EMN-MM-2025` `SRC-ESMO-MM-2023` `SRC-NCCN-MM-2025`

Red Flag Origin

Definition	t(11;14)(q13;q32) IGH/CCND1 translocation in multiple myeloma — ~15-20% prevalence, BCL-2-dependent / venetoclax-sensitive subset. Venetoclax-based regimens (BELLINI subgroup analysis: ven + bort + dex R/R MM mPFS 22.4 vs 11.6 mo in t(11;14) — vs no benefit in non-t(11;14)) drive R/R 2L+ selection.
Clinical direction	intensify
Category	high-risk-biology
Shifts algorithm	ALGO-MM-2L

Trigger Logic

{
  "any_of": [
    {
      "finding": "t11_14_translocation",
      "value": true
    },
    {
      "finding": "t_11_14_status",
      "value": "positive"
    },
    {
      "finding": "ccnd1_igh_fusion",
      "value": "positive"
    },
    {
      "finding": "fish_t11_14",
      "value": "positive"
    }
  ],
  "type": "biomarker"
}

Notes

BELLINI overall trial showed OS detriment in non-t(11;14) — venetoclax in MM is biomarker-restricted to t(11;14) (and emerging high BCL2 expression, BCL2/BCL2L1 ratio). Off-label use only — venetoclax not formally MM-approved (CANOVA confirmatory phase 3 in t(11;14) R/R MM ongoing). Increased infection risk on venetoclax + DCEP / bort / dex — PJP + VZV prophylaxis. Detection: standard MM FISH panel (also covers high-risk t(4;14), t(14;16), del(17p), gain/amp 1q21 — covered by RF-MM-HIGH-RISK-CYTOGENETICS).

Used By

Algorithms

ALGO-MM-2L - ALGO-MM-2L