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Clinical Trial
. 2016 Feb;101(2):e69-71.
doi: 10.3324/haematol.2015.128215. Epub 2015 Oct 15.

Minimal residual disease following autologous stem cell transplant in myeloma: impact on outcome is independent of induction regimen

Ruth M de Tute  1 , Andy C Rawstron  1 , Walter M Gregory  2 , J Anthony Child  2 , Faith E Davies  3 , Sue E Bell  2 , Gordon Cook  1 , Alexander J Szubert  2 , Mark T Drayson  4 , Graham H Jackson  5 , Gareth J Morgan  3 , Roger G Owen  6
Affiliations
Clinical Trial

Minimal residual disease following autologous stem cell transplant in myeloma: impact on outcome is independent of induction regimen

Ruth M de Tute et al. Haematologica. 2016 Feb.
No abstract available

Keywords: flow cytometry; induction; minimal residual disease; myeloma.

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Figures

Figure 1.
Figure 1.
Outcome following autologous stem cell transplant (ASCT) according to day 100 minimal residual disease (MRD) and induction therapy received. The impact of MRD on outcome did not differ according to induction therapy received. For MRD-negative patients the median PFS for CTD was 28.9 months versus 28.7 months for CVAD (P=0.54) (A) while the median OS was 80.6 months and not reached, respectively (P=0.81) (B). Similarly for MRD-positive patients, median PFS for CTD was 14.9 months versus 15.9 months for CVAD (P=0.96) (A) and median OS 58.7 months and 61.9 months, respectively (P=0.91) (B). A similar pattern is also seen when PFS analysis is restricted to complete response (CR) patients (C).
Figure 2.
Figure 2.
Induction regimens do not impact outcome when considered according to MRD assessed both at the end of induction and following ASCT. The outcome of patients who are MRD-negative at both time points (A), MRD-positive post induction and MRD-negative post ASCT (B) and positive at both time points (C) did not differ according to induction regimen (P=0.84, 0.56 and 0.79, respectively).
Figure 3.
Figure 3.
Impact of quantitative level of MRD on outcome. The outcome of MRD-positive patients with MRD levels of 0.01% – <0.1% (A), 0.1% – <1% (B) and greater than 1% (C) did not differ with induction regimen (P=0.84, 0.9 and 0.49, respectively).
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References

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    1. Paiva B, Gutierrez NC, Rosinol L, et al. High-risk cytogenetics and persistent minimal residual disease by multiparameter flow cytometry predict unsustained complete response after autologous stem cell transplantation in multiple myeloma. Blood. 2012;119(3):687–691. - PubMed
    1. Rawstron AC, Child JA, de Tute RM, et al. Minimal Residual Disease Assessed by Multiparameter Flow Cytometry in Multiple Myeloma: Impact on Outcome in the Medical Research Council Myeloma IX Study. J Clin Oncol. 2013;31(20):2540–2547. - PubMed
    1. Rawstron AC, Gregory WM, de Tute RM, et al. Minimal residual disease in myeloma by flow cytometry: independent prediction of survival benefit per log reduction. Blood. 2015;125(12):1932–1935. - PMC - PubMed
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