Predicting risk of progression in relapsed multiple myeloma using traditional risk models, focal lesion assessment with PET-CT and minimal residual disease status

Baker, David L.; Bimali, Milan; Carrillo, Luis; Sachedina, Archana; Alapat, Daisy; Hoque, Shadiqul; Kottarathara, Mathew; Parikh, Richa; Erra, Amani; Mitma, Angel A; Mathur, Pankaj; Ogunsesan, Yetunde; Yarlagadda, Lakshmi; Gundarlapalli, Sravani; Thanendrarajan, Sharmilan; Zangari, Maurizio; Rhee, Frits van; Tricot, Guido; Schinke, Carolina

doi:10.3324/haematol.2021.278779

Cited by 3 publications

(1 citation statement)

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“…This is supported by published data from the University of Arkansas for Medical Sciences (UAMS). In patients with newly diagnosed MM (NDMM) enrolled on total therapy trials, the frequency of residual disease captured by imaging was only 12% 14,16 . However, real‐world data supporting this observation is missing.…”

Section: Introductionmentioning

confidence: 99%

Minimal residual disease and imaging‐guided consolidation strategies in newly diagnosed and relapsed refractory multiple myeloma

et al. 2022

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Measurement of minimal residual disease (MRD) by next-generation flow cytometry (NGF) is an important tool to define deep responses in multiple myeloma (MM).However, little is known about the value of combining NGF with functional imaging and its role for MRD-based consolidation strategies in clinical routine. In the present study, we report our experience investigating these issues with 102 patients with newly diagnosed (n = 57) and relapsed/refractory MM (n = 45). Imaging was performed using either positron emission tomography or diffusion-weighted magnetic resonance imaging. In all, 45% of patients achieved MRD-negativity on both NGF and imaging (double-negativity), and 8% and 40% of patients were negative on either NGF or imaging respectively. Thus, in a minority of patients imaging was the only technique to detect residual disease. Imaging-positivity despite negativity on NGF was more common in heavily pretreated disease (four or more previous lines) compared to newly diagnosed MM (p < 0.01). Among the 29 patients undergoing MRD-triggered consolidation, 51% responded with MRD conversion and 21% with improved serological response. MRD-triggered consolidation led to superior progression-free survival (PFS) when compared to standard treatment (p = 0.04). In conclusion, we show that combining NGF with imaging is helpful particularly in patients with heavily pretreated MM, and that MRD-based consolidation could lead to improved PFS.

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Section: Introductionmentioning

confidence: 99%