Molecular remission after myeloablative allogeneic stem cell transplantation predicts a better relapse-free survival in patients with multiple myeloma.
Patients in complete clinical remission after myeloablative allogeneic stem cell transplantation (allo-SCT) were enrolled in a longitudinal study to assess the predictive value of molecular monitoring. Using polymerase chain reaction (PCR) for immunoglobulin gene rearrangements it was possible to generate a clone-specific molecular marker in 48 of 70 patients. Of these 48 patients, 16 (33%) attained durable PCR-negativity after transplantation, whereas 13 (27%) remained persistently PCR-positive and 19 (40%) showed a mixed pattern. The cumulative risk of relapse at 5 years was 0% for PCR-negative patients, 33% for PCR-mixed patients, and 100% for PCR-positive patients. Within the group studied it was not possible to identify any clinical feature predictive of durable PCR-negativity. We believe that these findings could prompt the design of prospective studies to evaluate if the treatment of molecular disease can extend remission duration and survival.
Hematology-Bone Marrow Transplantation Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via Venezian, 1, 20133 Milan, Italy. paolo.corradini@unimi.it
Paolo
P
Corradini
Michele
M
Cavo
Henk
H
Lokhorst
Giovanni
G
Martinelli
Carolina
C
Terragna
Ignazio
I
Majolino
Pinuccia
P
Valagussa
Mario
M
Boccadoro
Diana
D
Samson
Andrea
A
Bacigalupo
Nigel
N
Russell
Vittorio
V
Montefusco
Claudia
C
Voena
Gosta
G
Gahrton
D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D015322:Gene Rearrangement, B-Lymphocyte / Q000235:genetics*; D005819:Genetic Markers; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D012307:Risk Factors
D005819:Genetic Markers