Title:Long-term CR Multiple Myeloma Patients Show Cured or MGUS-like
Minimal Residual Disease Pattern by Next Generation Flow
Volume: 17
Issue: 2
Author(s): Alessandro Gozzetti*, Paola Pacelli, Donatella Raspadori, Elena Bestoso, Dania Tocci, Anna Sicuranza and Monica Bocchia
Affiliation:
- Hematology, University of Siena, Azienda Ospedaliera Universitaria Senese, Policlinico “Santa Maria alle Scotte”,
Siena, Italy
Keywords:
Multiple myeloma, minimal residual disease, next-generation flow, complete remission, monoclonal plasma cells, bone marrow.
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.