Controversies in the Assessment of Minimal Residual Disease in Multiple Myeloma: Clinical Significance of Minimal Residual Disease Negativity Using Highly Sensitive Techniques
Controversies in the Assessment of Minimal Residual Disease in Multiple Myeloma: Clinical Significance of Minimal Residual Disease Negativity Using Highly Sensitive Techniques
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DOI：
10.1007/s11899-014-0237-y
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发表时间：
2014-12-01
影响因子：
2.9
通讯作者：
Chari, Ajai
中科院分区：
文献类型：
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作者：
Biran, Noa;Ely, Scott;Chari, Ajai
微小残留病(MRD)评估在多发性骨髓瘤的疗效评估中具有重要意义。正如这个由两部分组成的系列的第1部分所讨论的，骨髓和外周血的多参数流式细胞术、聚合酶链式反应和下一代测序等技术有可能实现高水平的敏感性，高达10(-6)个细胞中的1个，从而能够分析不同基因的亚克隆。在这里，我们回顾了使用这些技术评估MRD的临床实用价值。具体地说，我们回顾了在不同的临床环境下(诱导后、自体或异基因干细胞移植后、移植不合格、维持性和复发/难治)中MRD阴性与无进展或总存活率之间的关系。目前，评估多发性骨髓瘤(MM)的MRD的目标是允许采用风险分层的治疗方法，并更早地确定对新药物的反应，特别是在临床试验的背景下。
Minimal residual disease (MRD) assessment has gained importance in the response evaluation of multiple myeloma. As discussed in part 1 of this two-part series, techniques such as multiparameter flow cytometry, polymerase chain reaction, and next-generation sequencing, of both bone marrow and peripheral blood, have the potential to achieve a high level of sensitivity, up to 1 in 10(-6) cells, enabling analysis of genetically diverse subclones. Here, we review the clinical utility of MRD assessment using these techniques. Specifically, we review the association between MRD-negativity and progression-free or overall survival in various clinical settings (post-induction, post-auto or allostem cell transplant, transplant ineligible, maintenance, and relapsed/refractory). Currently, the goal of assessing MRD in multiple myeloma (MM) is to allow for a risk-stratified approach to therapy and for earlier identification of response to novel agents, particularly in the setting of clinical trials.