[Music] what is a 17p deletion and why is it considered high risk chromosomes have numbers and chromosomes of arms long arm q short arm p we are talking about chromosome number 17 the short arm of chromosome 17. in that area is located a major regulator of life and death decisions that's called p53 p53 is a major player in molecular player in cancer because it's one of those cells that regulates these life and death decisions it's not only relevant to myeloma it's one of the most commonly altered genes in human cancer but it's particularly relevant for myeloma because it seems to be it seems to be the case that plasma cells that are the relevant cells in myeloma are exquisitely sensitive to life or death decisions that are made by b53 so p53 is a tumor suppressor gene in its natural form so it's there to protect your body or to protect plasma cells against cancer if you want to put it plainly so when you start losing the area of chromosome where this molecular break if you want resides then the cells consider this a license to continue dividing and set the stage for myeloma it's important to know what the p53 status is for each one of our patients that's one of the tests that are part of the standard staging and what we call risk stratification and it's the case that patients with abnormalities in the short term of chromosome 17 and in the gene that we call p53 have a aggressive course for their myeloma the finding of 17p deletion is a high risk marker in the future will become better at stratifying even in a more fine and detailed way patients with several different um possibilities of taking this very important gene out of function and so it's an evolving field we the tests are becoming better at declaring the exact abnormalities affecting the p53 locus and the number of cells that harbor these abnormalities so what we expect to find is that in the future within this group we will be able to discriminate in a more fine ability where with a finer ability what exactly these different groups of patients represent with regard to risk i think that for now everybody in the myeloma field would consider the finding of a 17p abnormality by conventional cytogenetics and risk certification that we do today to be a high risk marker that places the patient in that category right so in the old days it was enough to declare whether we could find a deletion or not what we realize is that the percentage of cells that contain an abnormality of 17p matters and the exact cutoff is still you know the subject of active ongoing research so that's a field that is continuously evolving in the future we will not just declare a patient p53 positive or negative but we will also want to know the percentage of cells that carry this [Music] abnormality