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Minimal Residual Disease in Myeloma: Are We There Yet?

麦子添加于 2012-5-26 15:44 | 1576 次阅读 | 0 个评论

作者
Hart AJ, Jagasia MH, Kim AS, Mosse CA, Savani BN, Kassim A
摘要
Measurement of minimal residual disease (MRD) is routine in diseases such as chronic myelogenous leukemia (CML), precursor B-cell lymphoblastic leukemia (B-ALL), and acute promyelocytic leukemia (APL) because it provides important prognostic information. However, the role of MRD testing has not been widely adopted in multiple myeloma (MM), with other parameters such as International Staging System (ISS) and cytogenetic analysis primarily guiding therapy and determination of prognosis. Until recently, achieving a complete response (CR), as defined by International Myeloma Working Group (IMWG) criteria, was rare in patients with MM. The use of novel agents with or without autologous peripheral blood stem cell transplantation (auto-SCT) has significantly increased CR rates, thus increasing overall survival (OS) rates. The majority of MM patients have persistent levels of residual disease that are below the sensitivity of bone marrow morphology, protein electrophoresis with immunofixation, and light chain quantitation even after attaining CR and will eventually relapse. Measurement of MRD by more sensitive methods, and the use of these methods as a tool for predicting patient outcomes and guiding therapeutic decisions, has thus become more relevant. Methods available for monitoring MRD in MM include polymerase chain reaction (PCR) and multiparameter flow cytometry (MFC), both of which have been shown to be valuable in other hematologic malignancies; however, neither has become a standard of care in MM. Here, we review current evidence for using MRD measurement for risk assessment in MM as well as incorporating pre-treatment factors and post-treatment MRD monitoring as a prognostic tool for therapeutic decisions, and we outline challenges to developing uniform criteria for MRD monitoring.
详细资料
- 文献种类:期刊
- 期刊名称: Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
- 期刊缩写: Biol Blood Marrow Transplant
- 期卷页: 2012年
- 地址: Departments of Medicine, Division of Hematology/Oncology Section of Hematology and Stem Cell Transplant
- ISBN: 1083-8791
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