A large meta-analysis establishes the role of MRD negativity in long-term survival outcomes in patients with multiple myeloma
A large meta-analysis establishes the role of MRD negativity in long-term survival outcomes in patients with multiple myeloma
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DOI：
10.1182/bloodadvances.2020002827
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发表时间：
2020-12-08
期刊：
影响因子：
7.5
通讯作者：
Bahlis, Nizar
中科院分区：
文献类型：
--
作者：
Munshi, Nikhil C.;Avet-Loiseau, Herve;Bahlis, Nizar
采用系统性文献综述和荟萃分析，在一个大型多发性骨髓瘤（MM）患者队列中评价了微小残留病（MRD）对无进展生存期（PFS）和总生存期（OS）的预后价值。检索Medline和EMBASE数据库中截至2019年6月8日发表的文章，索引数据库没有日期限制。提取按MRD状态（阳性或阴性）分层的临床终点，包括PFS和OS的风险比（HR）、P值和置信区间（CI）。根据已发表的Kaplan-Meier曲线重建的患者水平数据估计HR。确定了44项合格研究（PFS数据来自8098例患者）和23项研究（OS数据来自4297例患者），以评估MRD状态与生存结局之间的相关性。与MRD阳性相比，MRD阴性可改善PFS（HR，0.33; 95%CI，0.29- 0.37; P
The prognostic value of minimal residual disease (MRD) for progression-free survival (PFS) and overall survival (OS) was evaluated in a large cohort of patients with multiple myeloma (MM) using a systematic literature review and meta-analysis. Medline and EMBASE databases were searched for articles published up to 8 June 2019, with no date limit on the indexed database. Clinical end points stratified by MRD status (positive or negative) were extracted, including hazard ratios (HRs) on PFS and OS, P values, and confidence intervals (CIs). HRs were estimated based on reconstructed patient-level data from published Kaplan-Meier curves. Forty-four eligible studies with PFS data from 8098 patients, and 23 studies with OS data from 4297 patients were identified to assess the association between MRD status and survival outcomes. Compared with MRD positivity, achieving MRD negativity improved PFS (HR, 0.33; 95% CI, 0.29- 0.37; P