Minimal residual disease evaluation in autologous stem cell transplantation recipients with multiple myeloma

Ning

et al. 2019

WJCC

BACKGROUNDThe guiding effect of prognostic stratification in multiple myeloma (MM) for treatment has been increasingly emphasized in recent years. The stratification of risk factors based on the International Staging System (ISS), Durie-Salmon (DS) staging and related indicators is affected by the renal function of patients, resulting in poor performance. This study assesses the relationship between interleukin-32 (IL-32) and related risk factors in 67 patients with MM and their clinical outcomes.AIMTo investigate the feasibility of IL-32 in evaluating prognosis in patients with MM and the factors influencing prognosis.METHODSThis was a pragmatic, prospective observational study of patients with MM at a single center. According to IL-32 level, patients were divided into two groups. The variables under consideration included age, blood β2-microglobulin, albumin, C-reactive protein, serum calcium, serum creatinine, lactate dehydrogenase, M protein type, ISS stage, DS stage, and IL-32 levels and minimal residual disease (MRD) after induction treatment. The main outcomes were progression-free survival (PFS) and overall survival (OS).RESULTSIL-32 was an important factor affecting PFS and OS in patients with MM. Compared with patients with IL-32 levels ≥ 856.4 pg/mL, patients with IL-32 levels < 856.4 pg/mL had longer PFS (P = 0.0387) and OS (P = 0.0379); Univariate analysis showed that IL-32 level and MRD were significantly associated with OS and PFS (P < 0.05). Multivariate analysis showed that IL-32 levels ≥ 856.4 pg/mL and MRD positive were still independent risk factors for OS and PFS (P < 0.05).CONCLUSIONIL-32 is valuable for assessing the prognosis of MM patients. IL-32 level combined with MRD may be a useful routine evaluation index for MM patients after treatment.

Section: Discussionsupporting

confidence: 86%

Expression of interleukin-32 in bone marrow of patients with myeloma and its prognostic significance

Ning

et al. 2019

WJCC

“…This may be because an MRD-negative status is a prognostic factor independent of cytogenetics ( 14 ). At present, studies have reported that an MRD-negative status can overcome the prognostic significance of poor cytogenetics, but some studies have reported that an MRD-negative status cannot overcome the prognostic impact of poor cytogenetics ( 7 , 16 – 19 ). However, there is currently no research discussing whether the stage at which an MRD-negative status is achieved can predict the prognosis of patients with high-risk cytogenetics; therefore, we believe that our conclusions are worthy of further verification with larger-scale data.…”

Section: Discussionmentioning

confidence: 99%

“…This study showed that for MM patients who received ASCT, the prognoses of those who achieved an MRD-negative status at different stages were different, and those who achieved an MRD-negative status after induction therapy had a better prognosis than those who achieved MRD-negative after maintenance. In most previous studies, MRD was detected 3 months after ASCT, and the test results were used as the basis for the efficacy evaluation and prognosis prediction ( 4 , 7 , 14 ). However, our research shows that there are differences in the prognoses of patients who achieve an MRD-negative status at different stages.…”

Section: Discussionmentioning

confidence: 99%

“…At the end of each treatment stage, traditional efficacy and MRD need to be evaluated ( 1 ). Patients who are MRD-negative have a better prognosis ( 2 , 3 , 7 ). Regardless of the stage at which an MRD-negative status is achieved, the lower the MRD level detected with a highly sensitive technique is, the longer the progression-free survival (PFS) and overall survival (OS) periods ( 4 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic Significance of the Stage at Which an MRD-Negative Status Is Achieved for Patients With Multiple Myeloma Who Received ASCT

Sun

et al. 2022

Front. Oncol.

ObjectiveTo explore the prognostic significance of the stage at which a minimal residual disease (MRD)-negative status is achieved for patients with newly diagnosed multiple myeloma (NDMM) who received autologous hematopoietic stem cell transplantation (ASCT).Cases and MethodsA retrospective analysis of 186 NDMM patients who received “induction therapy-ASCT-maintenance therapy” in our center and achieved an MRD-negative status was performed. Patients were divided into three groups, A (induction therapy), B (3 months after ASCT), and C (maintenance therapy), according to the stage at which an MRD-negative status was achieved.ResultsThe median time to progression (TTP) of 186 patients was not reached; the median overall survival (OS) was 113.8 months. The median TTP of the patients in three groups was not reached (P=0.013), and the median OS of the patients in three groups was not reached, not reached, and 71.2 months, respectively (P=0.026). Among patients with standard-risk cytogenetics, the median TTP of those in all three groups was not reached (P=0.121), and the median OS of the patients in three groups was not reached, not reached, and 99.6 months, respectively (P=0.091). Among patients with high-risk cytogenetics, the median TTP of those in three groups was not reached, 53.9 months, and 35.8 months (P=0.060), and the median OS was not reached, 71.2 months, and 60.2 months, respectively (P=0.625). Among patients with R-ISS stage I-II, the median TTP of those in three groups was not reached (P=0.174), and the median OS of the patients in three groups was not reached, not reached, and 99.6 months, respectively (P=0.186). Among the 29 patients with R-ISS stage III, the median TTP of those in the 3 groups were unreached, unreached, and 35.1 months (P<0.001), and the median OS was unreached, unreached, and 48.5 months, respectively (P=0.020). In all enrolled patients, the stage of reaching MRD-negative was an independent prognostic factor for TTP, rather than a prognostic factor for OS. The stage of reaching MRD-negative in patients with R-ISS III was an independent prognostic factor for OS.ConclusionFor the same patients who are MRD-negative, the prognoses of those who achieve an MRD-negative status at different groups are different. The stage at which an MRD-negative status is achieved can predict the prognosis of patients with R-ISS stage III.

Indian J Med Paediatr Oncol

“…The backbone gating markers for the PC analysis strategy are CD38, CD138, and CD45. 38 39 However, in the era of targeted therapy especially in the setting of use of anti-CD38 monoclonal antibody in the treatment protocols, a search for alternate gating markers for PC continues. In quest of newer markers for PC identification, Pojero et al carried out a detailed analysis of several PC-associated markers and demonstrated that CD54 and CD319 had limited utility for PC identification because of significant overlap of the staining on PCs and other myeloid cells in the sample.…”

Section: Analytical Considerations For Mfc-based Mrd Detectionmentioning

confidence: 99%

Voyage of Measurable Residual Disease Assessment in Multiple Myeloma Using Multiparametric Flow Cytometry

Das

Gupta

2023

Self Cite

Measurable residual disease (MRD) in multiple myeloma (MM) has emerged as one of the strongest and independent biomarkers to evaluate therapeutic response for the prediction of long-term treatment outcome. With the incorporation of MRD in response assessment criterion by International Myeloma Working Group, it has become the routine parameter to be assessed at various time points after therapy. Among various techniques to assess MRD, multiparametric flow cytometry (MFC)-based MRD estimation has evolved dramatically over the last two decades achieving sensitivity comparable to molecular methods. Next-generation flow cytometry with the incorporation of innovative tools in MRD detection including consortium-based guidelines for preanalytical and analytical factors led to the overall improvement in MFC-based MRD detection. However, flow cytometry assays suffer from inherent challenges ranging from procedural hemodilution to lack of harmonization and standardization across the centers.This review article outlines and summarizes the essential laboratory prerequisites for reproducible MRD analysis by flow cytometry. Furthermore, a brief account of the utility of MRD evaluation in clinical practice as predictor of response and long-term treatment outcome has also been discussed. Considering the evolution of MFC-based MRD over two decades from a scientific research tool to a routine clinical diagnostic assay, it needs to be explored further in studying complex phenomenon like clonal evolution, clonal switches, and identification of treatment refractory clones for guiding more effective therapies improving overall survival.