Minimal Residual Disease Assessment in Multiple Myeloma Patients: Minimal Disease With Maximal Implications.
Minimal Residual Disease Assessment in Multiple Myeloma Patients: Minimal Disease With Maximal Implications.
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DOI：
10.3389/fonc.2021.801851
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发表时间：
2021
影响因子：
4.7
通讯作者：
Kourelis T
中科院分区：
文献类型：
--
作者：
Charalampous C;Kourelis T
多发性骨髓瘤（MM）是第二常见的血液系统恶性肿瘤，在过去的二十年里，已经成为许多治疗进展的目标。在目前的标准治疗中，新型药物（如蛋白酶体抑制剂、免疫调节药物和单克隆抗体）的引入以及自体造血干细胞移植（ASCT）的沿着，显著提高了骨髓瘤患者的中位生存期。然而，治愈性治疗选择仍然远离我们，MM仍然是一种不治之症，患者即使在达到深度常规定义的缓解后也会复发，这强调了开发敏感方法的必要性，这些方法将允许适当识别和管理复发概率较高的患者。从骨髓活检中准确检测微小残留病（MRD）代表了一种相对较新的评估治疗反应的方法，数据显示在病程的任何时间点获得MRD（-）状态都有明显的益处。随着MM患者的预期寿命持续增加，深度缓解开始成为常态，建立和完善MRD在疾病过程中的作用比以往任何时候都更加重要。本文综述了用于检测MRD的不同方法，并讨论了未来在日常临床实践中实施的考虑因素，以及作为临床试验的前瞻性主要终点。
Multiple Myeloma (MM), the second most common hematologic malignancy, has been the target of many therapeutic advances over the past two decades. The introduction of novel agents, such as proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies, along with autologous hematopoietic stem cell transplantation (ASCT) in the current standard of care, has increased the median survival of myeloma patients significantly. Nevertheless, a curative treatment option continues to elude us, and MM remains an incurable disease, with patients relapsing even after achieving deep conventionally defined responses, underscoring the need for the development of sensitive methods that will allow for proper identification and management of the patients with a higher probability of relapse. Accurate detection of Minimal Residual Disease (MRD) from a bone marrow biopsy represents a relatively new approach of evaluating response to treatment with data showing clear benefit from obtaining MRD(-) status at any point of the disease course. As life expectancy for patients with MM continues to increase and deep responses are starting to become the norm, establishing and refining the role of MRD in the disease course is more relevant than ever. This review examines the different methods used to detect MRD and discusses future considerations regarding the implementation in day-to-day clinical practice and as a prospective primary endpoint for clinical trials.
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影响因子：
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