Minimal residual disease negativity and lenalidomide maintenance therapy are associated with superior survival outcomes in multiple myeloma.
Minimal residual disease negativity and lenalidomide maintenance therapy are associated with superior survival outcomes in multiple myeloma.
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DOI：
10.1038/s41409-020-0791-y
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发表时间：
2020-06
影响因子：
4.8
通讯作者：
Kassim, Adetola A.
中科院分区：
文献类型：
--
作者：
Patel, Dilan A.;Gopalakrishnan, Ragisha;Engelhardt, Brian G.;McArthur, Evonne;Sengsayadeth, Salyka;Culos, Katie A.;Byrne, Michael;Goodman, Stacey;Savani, Bipin N.;Chinratanalab, Wichai;Jagasia, Madan;Mosse, Claudio A.;Cornell, Robert F.;Kassim, Adetola A.
多发性骨髓瘤的现代综合治疗方法改善了生存结果，总有效率接近100%，完全有效率25%，尤其是自体造血细胞移植(AHCT)。多参数流式细胞术评估微小残留病(MRD)是无进展生存期(PFS)和总生存期(OS)的有效预后生物标志物。然而，关于MRD阳性或阴性是否会有意义地影响治疗决定的数据很少。我们评估了433名接受诱导治疗的患者，随后进行了AHCT。参与者在AHCT前、后+100天和+365天用多参数流式细胞仪进行MRD评估。他们在AHCT后也接受来那度胺、波特佐米或不接受维持治疗。接受来那度胺维持治疗的患者+365d的MRD阴性率明显高于未接受维持治疗的患者(92.9%vs41.6%，p=0.012)。MRD阴性患者+365d的中位PFS为42vs17.5个月(p<；0.001)，中位OS为80.6vs59个月(p=0.02)。多发性骨髓瘤AHCT后的维持治疗改善了MRD评估的反应深度。
Modern combinations of therapies for multiple myeloma have led to improvement in survival outcomes with near 100% overall response rate and 25% complete response rates, particularly with autologous hematopoietic cell transplant (AHCT). Minimal residual disease (MRD) assessment with multiparameter flow cytometry is a valid prognostic biomarker for progression-free survival (PFS) and overall survival (OS). However, few data exist regarding whether MRD positivity or negativity will meaningfully influence treatment decisions. We evaluated 433 patients who received induction therapy, followed by AHCT. Participants had MRD assessment by multiparameter flow cytometry before and at days +100 and +365 following AHCT. They also received either lenalidomide, bortezomib, or no maintenance therapy following AHCT. Maintenance treatment with lenalidomide improved MRD negativity at day +365 compared to bortezomib (92.9% vs 41.6%, p = 0.01), or no maintenance therapy (92.9% vs 24.4%, p = 0.012). The median PFS for patients who were MRD negative at day + 365 was 42 vs 17.5 months (p < 0.001) and median OS was 80.6 vs 59 months (p = 0.02). Maintenance therapy following AHCT for multiple myeloma improves the depth of response as assessed by MRD.
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影响因子：
20.3
作者：
Fermand, JP;Ravaud, P;Brouet, JC
通讯作者：
Brouet, JC
DOI：
10.1038/nrclinonc.2014.239
发表时间：
2015-05
期刊：
Nature reviews. Clinical oncology
影响因子：
--
作者：
Mailankody S;Korde N;Lesokhin AM;Lendvai N;Hassoun H;Stetler-Stevenson M;Landgren O
通讯作者：
Landgren O
影响因子：
11.4
作者：
Durie, B. G. M.;Harousseau, J-L;Rajkumar, S. V.
通讯作者：
Rajkumar, S. V.
影响因子：
4.3
作者：
Holstein, Sarah A.;Avet-Loiseau, Herve;McCarthy, Philip L.
通讯作者：
McCarthy, Philip L.
影响因子：
11.4
作者：
Kyle, R. A.;Rajkumar, S. V.
通讯作者：
Rajkumar, S. V.