Summary of the Third Annual Blood and Marrow Transplant Clinical Trials Network Myeloma Intergroup Workshop on Minimal Residual Disease and Immune Profiling

Holstein, Sarah A.; Al-Kadhimi, Zaid; Costa, Luciano J.; Hahn, Theresa; Hari, Parameswaran; Hillengaß, Jens; Jacob, Allison P.; Munshi, Nikhil C.; Oliva, Stefania; Pasquini, Marcelo C.; Stadtmauer, Edward A.; Waldvogel, Stephanie

doi:10.1016/j.bbmt.2019.09.015

Cited by 15 publications

(8 citation statements)

References 86 publications

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“…54 Minimal residual disease testing has been developed for MM, and its role is actively being defined for prognostication and treatment decision-making in the induction, transplant, consolidation, and maintenance settings. 55 This technology is in its initial stages of development and application for WM and may help clarify the role for hematopoietic cell transplantation in WM. Identifying optimal timing for stem cell transplantation remains an open question that bears addressing in future studies, as does developing strategies to reduce NRM, notably in allo-HCT.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Autologous and Allogeneic Hematopoietic Cell Transplantation in Waldenström Macroglobulinemia: A Systematic Review and Meta-analysis

Parrondo

Reljic

Iqbal

et al. 2020

Clinical Lymphoma Myeloma and Leukemia

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We performed a systematic review and meta-analysis of all the available data to assess the efficacy of autologous (AHCT) and allogeneic (allo-HCT) hematopoietic cell transplantation for Waldenström macroglobulinemia. Both AHCT and allo-HCT are efficacious, resulting in complete response rates of around 20% with allo-HCT affording a 2-fold lower relapse rate, which is offset by a 7-fold higher non-relapse mortality compared with AHCT. Introduction: Waldenström macroglobulinemia (WM) is an IgM-producing lymphoproliferative disorder that remains incurable. Patients with high-risk disease have an overall survival (OS) of less than 3 years. Both autologous (AHCT) and allogeneic (allo-HCT) hematopoietic cell transplantation (HCT) are prescribed for treatment of WM despite a lack of randomized controlled studies. Materials and Methods: We performed a comprehensive literature search using PubMed/Medline and EMBASE on September 10, 2019. Data on clinical outcomes related to benefits and harms was extracted independently by 3 authors. Fifteen studies (8 AHCT [n ¼ 278 patients], 7 allo-HCT [n ¼ 311 patients]) were included in this systematic review/meta-analysis. Results: Pooled OS, progression-free survival (PFS), and nonrelapse mortality (NRM) rates post AHCT were 76% (95% confidence interval [CI], 65%-86%), 55% (95% CI, 42%-68%), and 4% (95% CI, 1%-7%), respectively. Pooled OS, PFS, and NRM rates post allografting were 57% (95% CI, 50%-65%), 49% (95% CI, 42%-56%), and 29% (95% CI, 23%-34%), respectively. OS and PFS rates were reported at 3 to 5 years, and NRM was reported at 1 year in most studies. Pooled ORR (at day 100) post AHCT and allo-HCT were 85% (95% CI, 72%-94%) and 81% (95% CI, 69%-91%), respectively. Pooled complete response rates post AHCT and allo-HCT were 22% (95% CI, 17%-28%) and 26% (95% CI, 7%-50%), respectively. Relapse rates post AHCT and allo-HCT were 42% (95% CI, 30%-55%) and 23% (95% CI, 18%-28%), respectively. Conclusions: Our results show that both AHCT and allo-HCT are effective in the treatment of WM. A 2-fold lower relapse rate but a 7-fold higher NRM was noted for allo-HCT compared with AHCT. The role of transplant in WM needs to be addressed in the era of novel agents.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Autologous and Allogeneic Hematopoietic Cell Transplantation in Waldenström Macroglobulinemia: A Systematic Review and Meta-analysis

Parrondo

Reljic

Iqbal

et al. 2020

Clinical Lymphoma Myeloma and Leukemia

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“…With the rapid development and availability of new treatment choices for MM, MM patients will have the opportunity to achieve appreciable treatment responses. The Blood and Marrow Transplant Clinical Trials Network Myeloma Intergroup Workshop (BMT CTN Myeloma Intergroup Workshop) has indicated that MRD detection and immune monitoring are important for MM patients ( 97 – 99 ). Based on the discussion put forth by our review, we know that certain immune profiling such as ACL and B cell absolute counts can be used for the prediction of prognosis of real-world myeloma patients.…”

Section: Discussionmentioning

confidence: 99%

Predictive Role of Immune Profiling for Survival of Multiple Myeloma Patients

Liu

2021

Front. Immunol.

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Despite new efficacy drugs and cell therapy have been used for multiple myeloma (MM) patients, some patients will relapse over time. We wonder the immune system play a vital role as well as MM cell during the development of disease. It is clear that the characteristic of myeloma cell is associated with the survival of MM patients. However, the link between the immune profiling and the prognosis of the disease is still not entirely clear. As more study focus on the role of immunity on multiple myeloma pathogenesis. There are plenty of study about the predictive role of immunity on the survival of multiple myeloma patients. Up to mow, the majority reviews published have focused on the immunotherapy and immune pathogenesis. It is indispensable to overlook the predictive role of immunity on multiple myeloma patients. Here, we give a review of vital previous works and recent progress related to the predictive role of immune profiling on multiple myeloma, such as absolute lymphocyte count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocytes and cytokines.

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“…The use of MRD as a sur ro gate end point for reg u la tory pur poses is an area of active dis cus sion 25 and is being addressed by a con sor tium of aca demic groups and phar ma ceu ti cal part ners, the International Independent Team for Endpoint Approval of Myeloma MRD. [26][27][28] The depth of MRD neg a tive sta tus is also impor tant. This was ini tially shown with flow cytom e try with sen si tiv ity down to 10 −4 and where each log reduc tion in MRD trans lated into improvement in median OS.…”

Section: Importance Of Depth Of Responsementioning

confidence: 99%

Minimal residual disease in multiple myeloma: why, when, where

Yee

Raje

2021

Hematology

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Improvements in multiple myeloma therapy have led to deeper responses that are beyond the limit of detection by historical immunohistochemistry and conventional flow cytometry in bone marrow samples. In parallel, more sensitive techniques for assessing minimal residual disease (MRD) through next-generation flow cytometry and sequencing have been developed and are now routinely available. Deep responses when measured by these assays correspond with improved outcomes and survival. We review the data supporting MRD testing as well as its limitations and how it may fit in with current and future clinical practice.

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Summary of the Third Annual Blood and Marrow Transplant Clinical Trials Network Myeloma Intergroup Workshop on Minimal Residual Disease and Immune Profiling

Cited by 15 publications

References 86 publications

Efficacy of Autologous and Allogeneic Hematopoietic Cell Transplantation in Waldenström Macroglobulinemia: A Systematic Review and Meta-analysis

Efficacy of Autologous and Allogeneic Hematopoietic Cell Transplantation in Waldenström Macroglobulinemia: A Systematic Review and Meta-analysis

Predictive Role of Immune Profiling for Survival of Multiple Myeloma Patients

Minimal residual disease in multiple myeloma: why, when, where

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