Abstract
Background: In the era of novel agents, many multiple myeloma patients can achieve a complete remission, but most of them relapse, and minimal residual disease detection can play a crucial role. Next-generation flow (NGF) can detect monoclonal plasma cells with a sensitivity of 10-6. Little is known about long-term remission patients (> 2 years) and in particular, if more sensitive techniques such as NGF can still detect minimal disease in those patients.
Objective: Aim of the study was to analyze patients with MM in response to NGF at > 2 years of sustained remission after several treatments.
Methods: MRD was studied by NGF in bone marrow aspirates according to Euroflow Consortium indications.
Results: 62 patients with sustained CR at >2 years were studied, MRD+ status was detected at a threshold cut-off of 10-6 in 32/62 (52%); 4/15 (27%) patients were MRD positive at >5 years of remission and they displayed a prevalence of normal vs abnormal monoclonal plasma cell immune-phenotype (MGUS-like).
Conclusion: NGF is a powerful technique to detect MRD. Myeloma patients in prolonged sustained complete remission can show in high percentage an MRD negative status or MGUS like.
Keywords: Multiple myeloma, minimal residual disease, next-generation flow, complete remission, monoclonal plasma cells, bone marrow.
Graphical Abstract
[http://dx.doi.org/10.3389/fonc.2014.00241] [PMID: 25237651]
[http://dx.doi.org/10.1038/leu.2013.350] [PMID: 24253022]
[http://dx.doi.org/10.1016/j.clml.2018.06.018] [PMID: 30030033]
[http://dx.doi.org/10.1182/blood-2007-10-116129] [PMID: 17975015]
[http://dx.doi.org/10.1002/ajh.24753] [PMID: 28383205]
[http://dx.doi.org/10.1111/bjh.15092] [PMID: 29315478]
[http://dx.doi.org/10.2174/1871524914999140818111514] [PMID: 25134940]
[http://dx.doi.org/10.1111/j.1600-0609.2010.01434.x] [PMID: 20192986]
[http://dx.doi.org/10.3389/fonc.2020.570187] [PMID: 33415072]
[http://dx.doi.org/10.1016/S1470-2045(16)30206-6] [PMID: 27511158]
[http://dx.doi.org/10.3390/jpm10030120] [PMID: 32927719]
[http://dx.doi.org/10.1038/leu.2017.29] [PMID: 28104919]
[http://dx.doi.org/10.3324/haematol.11080] [PMID: 18268286]
[http://dx.doi.org/10.1002/cyto.b.20439] [PMID: 18942105]
[http://dx.doi.org/10.1309/AJCP1GYI7EHQYUYK] [PMID: 19846814]
[http://dx.doi.org/10.1016/j.jim.2016.12.006] [PMID: 28041941]
[http://dx.doi.org/10.1002/cyto.b.20429] [PMID: 18548614]
[http://dx.doi.org/10.1080/14737159.2017.1332996] [PMID: 28524737]
[http://dx.doi.org/10.1111/bjh.15075] [PMID: 29265356]
[http://dx.doi.org/10.3389/fonc.2019.00449] [PMID: 31245284]
[http://dx.doi.org/10.1182/blood-2018-06-858613] [PMID: 30249784]
[http://dx.doi.org/10.1097/HS9.0000000000000300] [PMID: 31976475]
[http://dx.doi.org/10.1001/jamaoncol.2016.3160] [PMID: 27632282]
[http://dx.doi.org/10.1038/leu.2013.166] [PMID: 23743858]
[http://dx.doi.org/10.1182/blood-2007-05-088443] [PMID: 17576818]
[http://dx.doi.org/10.1038/leu.2012.309] [PMID: 23183429]
[http://dx.doi.org/10.1038/leu.2012.296] [PMID: 23183428]
[http://dx.doi.org/10.1038/s41408-020-00366-3] [PMID: 33067414]