Mutations in the ras oncogene have been noted in plasma cells of myeloma, more commonly in the advanced phase of the disease.110111 Liu and colleagues examined the mutational status of the N- and K-ras genes in 160 newly diagnosed multiple myeloma patients enrolled on the ECOG phase III clinical trial E9486.112 The incidence of ras mutations was 39%. Patients with K-ras, but not N-ras, mutations had a significantly shorter median survival, 2.0 years versus 3.7 years, P < 0.02.112
Mutations of the tumor suppressor gene p53 have also been studied. The incidence of p53 point mutations in myeloma in one study was 13%.113 Mutations were more common (43%) in the more advanced and clinically aggressive forms of the myeloma.
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