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t(11;14)(q13;q32) translocação IGH/CCND1 em mieloma múltiplo — ~15-20% prevalência, BCL-2...

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IDRF-MM-T11-14-ACTIONABLE
TipoSinal de alerta
Estadoreviewed 2026-04-27 | pending_clinical_signoff
DoençasDIS-MM
FontesSRC-EHA-EMN-MM-2025 SRC-ESMO-MM-2023 SRC-NCCN-MM-2025

Origem da bandeira vermelha

Definiçãot(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.
Direcção clínicaintensificar
Categoriahigh-risk-biology
Algoritmo de deslocamentosALGO-MM-2L

Lógica de Desencadeamento

{
  "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"
}

Notas

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).

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Algoritmos