Minimal residual disease after transplantation or lenalidomide-based consolidation in myeloma patients: a prospective analysis

被引：32

作者：

Oliva, Stefania ^{[1
]}

Gambella, Manuela ^{[1
]}

Gilestro, Milena ^{[1
]}

Muccio, Vittorio Emanuele ^{[1
]}

Gay, Francesca ^{[1
]}

Drandi, Daniela ^{[2
]}

Ferrero, Simone ^{[2
]}

Passera, Roberto ^{[3
]}

Pautasso, Chiara ^{[1
]}

Bernardini, Annalisa ^{[1
]}

Genuardi, Mariella ^{[1
]}

Patriarca, Francesca ^{[4
]}

Saraci, Elona ^{[1
]}

Petrucci, Maria Teresa ^{[5
]}

Pescosta, Norbert ^{[6
]}

Liberati, Anna Marina ^{[7
]}

Caravita, Tommaso ^{[8
]}

Conticello, Concetta ^{[9
]}

Rocci, Alberto ^{[10
]}

Musto, Pellegrino ^{[11
]}

Boccadoro, Mario ^{[1
]}

Palumbo, Antonio ^{[1
]}

Omede, Paola ^{[1
]}

机构：

[1] Univ Turin, Azienda Ospeadliero Univ Citta Salute & Sci Torin, Div Hematol, Myeloma Unit, Turin, Italy

[2] Univ Turin, Div Hematol, Dept Mol Biotechnol & Hlth Sci, Turin, Italy

[3] Univ Turin, Azienda Osped Univ Citta Salute & Sci Torino, Div Nucl Med, Turin, Italy

[4] Azienda Osped Univ Udine, DISM Univ Udine, Udine, Italy

[5] Sapienza Univ Rome, Div Hematol, Dept Cellular Biotechnol & Hematol, Rome, Italy

[6] Osped Cent Bolzano, Ematol & Ctr TMO, Bolzano, Italy

[7] AO S Maria Terni, SC Oncoematol, Terni, Italy

[8] UOC Ematol S Eugenio ASL RM2 Roma, Rome, Italy

[9] Univ Catania, Div Ematol, Azienda Policlin OVE, Catania, Italy

[10] Cent Manchester Univ Hosp NHS Fdn Trust, Dept Haematol, Manchester Royal Infirm, Manchester, Lancs, England

[11] IRCCS CROB, Referral Canc Ctr Basilicata, Sci Direct, Rionero In Vulture, Pz, Italy

来源：

ONCOTARGET | 2017年 / 8卷 / 04期

关键词：

myeloma; MRD; ASO-RQ-PCR; novel agents; flow cytometry; FREE LIGHT-CHAIN; STEM-CELL TRANSPLANTATION; MULTIPARAMETER FLOW-CYTOMETRY; STRINGENT COMPLETE RESPONSE; TIME QUANTITATIVE PCR; MULTIPLE-MYELOMA; AUTOLOGOUS TRANSPLANTATION; IMAGING TECHNIQUES; PROGNOSTIC-FACTORS; IMMUNOFIXATION;

D O I：

10.18632/oncotarget.12641

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

We analyzed 50 patients who achieved at least a very good partial response in the RV-MM-EMN-441 study. Patients received consolidation with autologous stem-cell transplantation (ASCT) or cyclophosphamide-lenalidomide-dexamethasone (CRD), followed by Lenalidomide-based maintenance. We assessed minimal residual disease (MRD) by multi-parameter flow cytometry (MFC) and allelic-specific oligonucleotide real-time quantitative polymerase chain reaction (ASO-RQ-PCR) after consolidation, after 3 and 6 courses of maintenance, and thereafter every 6 months until progression. By MFC analysis, 19/50 patients achieved complete response (CR) after consolidation, and 7 additional patients during maintenance. A molecular marker was identified in 25/50 patients, 4/25 achieved molecular-CR after consolidation, and 3 additional patients during maintenance. A lower MRD value by MFC was found in ASCT patients compared with CRD patients (p = 0.0134). Tumor burden reduction was different in patients with high-risk vs standard-risk cytogenetics (3.4 vs 5.2, ln-MFC; 3 vs 6 ln-PCR, respectively) and in patients who relapsed vs those who did not (4 vs 5, ln-MFC; 4.4 vs 7.8 ln-PCR). MRD progression anticipated clinical relapse by a median of 9 months while biochemical relapse by a median of 4 months. MRD allows the identification of a low-risk group, independently of response, and a better characterization of the activity of treatments.

引用

页码：5924 / 5935

页数：12

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