1. Molecular remission after myeloablative allogeneic stem cell transplantation predicts a better relapse-free survival in patients with multiple myeloma
- Author
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Andrea Bacigalupo, Paolo Corradini, Nigel H. Russell, Carolina Terragna, Vittorio Montefusco, Giovanni Martinelli, P. Valagussa, Diana Samson, Gösta Gahrton, Mario Boccadoro, Michele Cavo, Ignazio Majolino, Henk M. Lokhorst, Claudia Voena, and University of Groningen
- Subjects
Oncology ,Adult ,Genetic Markers ,Male ,medicine.medical_specialty ,BLOOD ,POLYMERASE-CHAIN-REACTION ,medicine.medical_treatment ,Immunology ,Hematopoietic stem cell transplantation ,Biochemistry ,THERAPY ,HEMATOLOGIC MALIGNANCIES ,RANDOMIZED TRIAL ,Disease-Free Survival ,Predictive Value of Tests ,Recurrence ,Risk Factors ,Internal medicine ,VERSUS-HOST DISEASE ,medicine ,Humans ,HEMATOPOIETIC-CELLS ,Longitudinal Studies ,Prospective cohort study ,Gene Rearrangement, B-Lymphocyte ,Multiple myeloma ,business.industry ,Remission Induction ,Hematopoietic Stem Cell Transplantation ,Cell Biology ,Hematology ,Gene rearrangement ,BONE-MARROW TRANSPLANTATION ,Middle Aged ,medicine.disease ,Prognosis ,Minimal residual disease ,Surgery ,Transplantation ,Clinical trial ,CONTAMINATION ,Predictive value of tests ,Female ,business ,Multiple Myeloma ,Settore MED/15 - Malattie del Sangue - Abstract
Patients in complete clinical remission after myeloablative allogeneic stem cell transplantation (allo-SCT) were enrolled in a longitudinal study to assess the predictive value of molecular monitoring. Using polymerase chain reaction (PCR) for immunoglobulin gene rearrangements it was possible to generate a clone-specific molecular marker in 48 of 70 patients. Of these 48 patients, 16 (33%) attained durable PCR-negativity after transplantation, whereas 13 (27%) remained persistently PCR-positive and 19 (40%) showed a mixed pattern. The cumulative risk of relapse at 5 years was 0% for PCR-negative patients, 33% for PCR-mixed patients, and 100% for PCR-positive patients. Within the group studied it was not possible to identify any clinical feature predictive of durable PCR-negativity. We believe that these findings could prompt the design of prospective studies to evaluate if the treatment of molecular disease can extend remission duration and survival.
- Published
- 2003