1. Flow cytometry remission by Ig light chains ratio is a powerful marker of outcome in multiple myeloma after tandem autologous transplant: a real-life study
- Author
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Andrea Mengarelli, Maria Concetta Petti, Atelda Romano, Marco Canfora, Antonio Spadea, Svitlana Gumenyuk, Francesco Pisani, Giovanni Cigliana, Elena Papa, Valentina Summa, Roberta Merola, Francesco Marchesi, Serena Masi, Iole Cordone, Daniela Renzi, Laura Conti, Francesca Palombi, and Giulia Orlandi
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Neoplasm, Residual ,medicine.medical_treatment ,Urology ,Hematopoietic stem cell transplantation ,Immunoglobulin light chain ,Transplantation, Autologous ,Flow cytometry ,03 medical and health sciences ,0302 clinical medicine ,Multiple myeloma ,medicine ,Light chains ratio ,Flow cytometry remission ,Humans ,Survival analysis ,Aged ,biology ,medicine.diagnostic_test ,business.industry ,Research ,Minimal residual disease ,Hematopoietic Stem Cell Transplantation ,Middle Aged ,medicine.disease ,Flow Cytometry ,Prognosis ,Survival Analysis ,Surgery ,Autologous stem cell transplant ,Treatment Outcome ,Oncology ,030220 oncology & carcinogenesis ,biology.protein ,Female ,Immunoglobulin Light Chains ,Stem cell ,Antibody ,business ,030215 immunology - Abstract
Background The achievement of complete response (CR) significantly correlates with a better clinical outcome in multiple myeloma (MM) patients treated with autologous stem cell transplant (ASCT). The depth of response is one of the most relevant factors to predict patient’s outcome, however the definition of CR through standard criteria has shown several limitations. Methods In this study we evaluated the minimal residual disease (MRD) in 50 consecutive MM patients who underwent an up-front tandem ASCT in our center, using a single-tube six-colors flow cytometry assay (FC) based on intra-cytoplasmic immunoglobulin (cy-Ig) light chains ratio evaluated on patient-specific plasma cells (PC) immune profile, in a real-life setting. Results With a sensitivity up to 10−5, clonal-PC were documented by FC in 36.4 % (12/33) of patients in conventional CR after second transplant. The number of flow MRD-negative patients significantly increased after induction and first ASCT, but not between first and second transplant. The 5-years progression-free survival (5ys-PFS) of flow MRD-negative patients after second transplant was significantly better than patients who remained MRD-positive considering both all patients (5ys-PFS: 70 % vs 5 %) and patients in CR according to standard criteria (5ys-PFS: 67 % vs 0 %). Conclusions FC remission through cy-Ig light ratio on PC sub-populations is a sensitive, highly informative, low-cost and routinely applicable MRD assay, a powerful tool in treatment response evaluation and a crucial marker of outcome in MM.
- Published
- 2016