Abstract |
Minimal residual disease (MRD) assessment is standard in many hematologic malignancies but is considered investigational in multiple myeloma (MM). We report a prospective analysis of the prognostic importance of MRD detection by multiparameter flow cytometry (MFC) in 295 newly diagnosed MM patients uniformly treated in the GEM2000 protocol VBMCP/VBAD induction plus autologous stem cell transplantation [ASCT]). MRD status by MFC was determined at day 100 after ASCT. Progression-free survival (PFS; median 71 vs 37 months, P < .001) and overall survival (OS; median not reached vs 89 months, P = .002) were longer in patients who were MRD negative versus MRD positive at day 100 after ASCT. Similar prognostic differentiation was seen in 147 patients who achieved immunofixation-negative complete response after ASCT. Moreover, MRD(-) immunofixation-negative (IFx(-)) patients and MRD(-) IFx(+) patients had significantly longer PFS than MRD(+) IFx(-) patients. Multivariate analysis identified MRD status by MFC at day 100 after ASCT as the most important independent prognostic factor for PFS (HR = 3.64, P = .002) and OS (HR = 2.02, P = .02). Our findings demonstrate the clinical importance of MRD evaluation by MFC, and illustrate the need for further refinement of MM re-sponse criteria. This trial is registered at http://clinicaltrials.gov under identifier NCT00560053.
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Authors | Bruno Paiva, Maria-Belén Vidriales, Jorge Cerveró, Gema Mateo, Jose J Pérez, Maria A Montalbán, Anna Sureda, Laura Montejano, Norma C Gutiérrez, Alfonso García de Coca, Natalia de Las Heras, Maria V Mateos, Maria C López-Berges, Raimundo García-Boyero, Josefina Galende, Jose Hernández, Luis Palomera, Dolores Carrera, Rafael Martínez, Javier de la Rubia, Alejandro Martín, Joan Bladé, Juan J Lahuerta, Alberto Orfao, Jesús F San Miguel, GEM (Grupo Español de MM)/PETHEMA (Programa para el Estudio de la Terapéutica en Hemopatías Malignas) Cooperative Study Groups |
Journal | Blood
(Blood)
Vol. 112
Issue 10
Pg. 4017-23
(Nov 15 2008)
ISSN: 1528-0020 [Electronic] United States |
PMID | 18669875
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Chemical References |
- Bleomycin
- Mitomycin
- Vincristine
- Dexamethasone
- Doxorubicin
- Cisplatin
- Carmustine
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Topics |
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage)
- Bleomycin
(administration & dosage)
- Carmustine
(administration & dosage)
- Cisplatin
(administration & dosage)
- Dexamethasone
(administration & dosage)
- Disease-Free Survival
- Doxorubicin
(administration & dosage)
- Female
- Flow Cytometry
(methods)
- Humans
- Male
- Middle Aged
- Mitomycin
(administration & dosage)
- Multiple Myeloma
(blood, diagnosis, mortality, therapy)
- Neoplasm, Residual
- Predictive Value of Tests
- Stem Cell Transplantation
(methods)
- Survival Rate
- Transplantation, Autologous
- Vincristine
(administration & dosage)
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