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Making clinical decisions based on measurable residual disease improves the outcome in multiple myeloma
- Source :
- Journal of Hematology & Oncology, Journal of Hematology & Oncology, Vol 14, Iss 1, Pp 1-4 (2021), Journal of hematology & oncology, vol 14, iss 1
- Publication Year :
- 2021
-
Abstract
- The assessment of measurable residual disease (MRD) in bone marrow has proven of prognostic relevance in patients with multiple myeloma (MM). Nevertheless, and unlike other hematologic malignancies, the use of MRD results to make clinical decisions in MM has been underexplored to date. In this retrospective study, we present the results from a multinational and multicenter series of 400 patients with MRD monitoring during front-line therapy with the aim of exploring how clinical decisions made based on those MRD results affected outcomes. As expected, achievement of MRD negativity at any point was associated with improved PFS versus persistent MRD positivity (median PFS 104 vs. 45 months, p p = 0.005). In patients who achieved MRD negativity during maintenance (n = 186) on at least one occasion, stopping therapy in 24 patients vs. continuing in 162 did not alter PFS (mPFS 120 months vs. 82 months, p = 0.1). Most importantly, however, in patients with a positive MRD during maintenance (n = 214), a clinical decision (either intensification or change of therapy) (n = 43) resulted in better PFS compared to patients in whom no adjustment was made (n = 171) (mPFS NA vs. 39 months, p = 0.02). Interestingly, there were no significant differences when MRD was assessed by flow cytometry or by next-generation sequencing. Herein, we find that MRD is useful in guiding clinical decisions during initial therapy and has a positive impact on PFS in MM patients. This potentially opens a new dimension for the use of MRD in MM, but this role still remains to be confirmed in prospective, randomized clinical trials.
- Subjects :
- Oncology
Male
Cancer Research
Neoplasm, Residual
Disease
Cardiorespiratory Medicine and Haematology
law.invention
Randomized controlled trial
law
Multiple myeloma
hemic and lymphatic diseases
Letter to the Editor
RC254-282
Cancer
screening and diagnosis
Hematology
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Disease Management
Middle Aged
Prognosis
Detection
medicine.anatomical_structure
Treatment Outcome
Residual
Female
4.2 Evaluation of markers and technologies
medicine.medical_specialty
Measurable residual disease
Oncology and Carcinogenesis
Clinical Decision-Making
Rare Diseases
Clinical Research
Internal medicine
medicine
Humans
Diseases of the blood and blood-forming organs
Molecular Biology
Retrospective Studies
business.industry
Minimal residual disease
Retrospective cohort study
medicine.disease
Discontinuation
body regions
Neoplasm
Bone marrow
RC633-647.5
business
Subjects
Details
- ISSN :
- 17568722
- Volume :
- 14
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of hematologyoncology
- Accession number :
- edsair.doi.dedup.....0b70413b5b3709a47ac8777a10647e54