Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/11344
The clinical significance of stringent complete response in multiple myeloma is surpassed by minimal residual disease measurements.
PLoS One 2020 ;15(8):e0237155.
Stringent complete response (sCR) is used as a deeper response category than complete response (CR) in multiple myeloma (MM) but may be of limited value in the era of minimal residual disease (MRD) testing. Here, we used 4-colour multiparametric flow cytometry (MFC) or next-generation sequencing (NGS) of immunoglobulin genes to analyse and compare the prognostic impact of sCR and MRD monitoring. We included 193 treated patients in two institutions achieving CR, for which both bone marrow aspirates and biopsies were available. We found that neither the serum free light chain ratio, clonality by immunohistochemistry (IHC) nor plasma cell bone marrow infiltration identified CR patients at distinct risk. Patients with sCR had slightly longer progression-free survival. Nevertheless, persistent clonal bone marrow disease was detectable using MFC or NGS and was associated with significantly inferior outcomes compared with MRD-negative cases. Our results confirm that sCR does not predict a different outcome and indicate that more sensitive techniques are able to identify patients with differing prognoses. We suggest that MRD categories should be implemented over sCR for the future classification of MM responses.
Adult | Aged | Aged, 80 and over | Bone Marrow | Data Accuracy | Female | Flow Cytometry | Follow-Up Studies | High-Throughput Nucleotide Sequencing | Humans | Immunoglobulin Light Chains | Male | Middle Aged | Multiple Myeloma | Neoplasm, Residual | Plasma Cells | Prognosis | Progression-Free Survival | Retrospective Studies
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