期刊
BLOOD
卷 123, 期 20, 页码 3073-3079出版社
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2014-01-550020
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资金
- Fondo de Investigaciones Sanitarias [PS09/01370, PS09/1450, PI12/01761, PI12/023121]
- Red de Cancer (Cancer Network of Excellence) from the Instituto de Salud Carlos III, Spain [RD12/10]
- Fondo de Investigaciones Sanitarias
- Asociacion Espanola Contra el Cancer (AECC) [GCB120981SAN]
- CRIS foundation
- Sequenta, Inc.
We assessed the prognostic value of minimal residual disease(MRD) detection in multiple myeloma(MM) patients using a sequencing-based platform in bone marrow samples from 133 MM patients in at least very good partial response (VGPR) after front-line therapy. Deep sequencing was carried out in patients in whom a high-frequency myeloma clone was identified and MRD was assessed using the IGH-VDJ(H), IGH-DJ(H), and IGK assays. The results were contrasted with those of multiparametric flow cytometry (MFC) and allele-specific oligonucleotide polymerase chain reaction (ASO-PCR). The applicability of deep sequencing was 91%. Concordance between sequencing and MFC and ASO-PCR was 83% and 85%, respectively. Patients who were MRD- by sequencing had a significantly longer time to tumor progression (TTP) (median 80 vs 31 months; P < .0001) and overall survival (median not reached vs 81 months; P = .02), compared with patients who were MRD+. When stratifying patients by different levels of MRD, the respective TTP medians were: MRD >= 10(-3) 27 months, MRD 10(-3) to 10(-5) 48 months, and MRD <10(-5) 80 months (P = .003 to .0001). Ninety-two percent of VGPR patients were MRD+. In complete response patients, the TTP remained significantly longer for MRD- compared with MRD+ patients (131 vs 35 months; P = .0009).
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