Minimal residual disease in multiple myeloma: bringing the bench to the bedside.
Minimal residual disease in multiple myeloma: bringing the bench to the bedside.
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DOI：
10.1038/nrclinonc.2014.239
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发表时间：
2015-05
期刊：
影响因子：
--
通讯作者：
Landgren O
中科院分区：
文献类型：
--
作者：
Mailankody S;Korde N;Lesokhin AM;Lendvai N;Hassoun H;Stetler-Stevenson M;Landgren O
过去十年中，多发性骨髓瘤 (MM) 患者的预后有了显着改善，无进展生存期和总生存期均有所改善。现在，许多患者对治疗已达到完全缓解，因此需要高灵敏度的检测方法来检测 MM 患者的微小残留病 (MRD)。多色流式细胞术和深度测序研究的结果表明，在获得完全缓解的患者中，MRD 阴性状态与无进展生存期和总生存期的显着改善相关。尽管 MM 患者对 MRD 检测的需求不断增加，但 MRD 检测技术的相当大的异质性阻碍了其结果的临床解释。用于定义 MRD 的标准、主要测试类型（流式细胞术与分子测试）的优缺点以及最佳样本类型（骨髓抽吸与外周血）都是 MRD 测试中尚未解决的难题。本综述概述了 MM 患者 MRD 检测的各种技术。此外，本文还讨论了常规使用 MRD 检测的挑战和机遇、临床试验未来可能的方向以及对药物审批流程的影响。
Outcomes for patients with multiple myeloma (MM) have improved substantially in the past decade, with improvements in both progression-free survival and overall survival. Many patients are now achieving a complete response to treatment, and consequently highly sensitive assays are needed for detection of minimal residual disease (MRD) in patients with MM. Results of multicolour flow cytometry and deep-sequencing studies suggest that among patients achieving a complete response, MRD-negative status is associated with significant improvements in progression-free survival and overall survival. Despite the increasing need for MRD testing in patients with MM, considerable heterogeneity in techniques for MRD detection hinders the clinical interpretation of their results. The criteria used to define MRD, strengths and weaknesses of the major types of tests (flow cytometry versus molecular testing), and the optimal sample type (bone marrow aspirate versus peripheral blood) are all unresolved dilemmas in MRD testing. This Review presents an overview of the various techniques for MRD detection in patients with MM. In addition, this article discusses challenges and opportunities for the routine use of MRD testing, possible future directions for clinical trials and implications for drug approval processes.
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