Prognostic role of minimal residual disease in multiple myeloma patients after non-myeloablative allogeneic transplantation.
This study evaluates the prognostic value of molecular monitoring of minimal residual disease (MRD) in 20 patients with multiple myeloma (MM) following autologous (peripheral blood stem cell transplantation, PBSCT) and non-myeloablative allogeneic (NMT) transplant. All patients completed their program, with a treatment-related mortality (TRM) of 20% and a 2-year progression-free survival (PFS) of 51%. After PBSCT, only 3 patients (15%) achieved PCR-negativity, versus 12 (60%) after NMT. The eradication of MRD had a favorable impact on 2-year OS. In fact, 76% of patients with no detectable MRD was still alive versus 34% of persistently IgH-positive cases (p=0.03). PCR status did not correlate with chimerism percentage: Seventy-five percent of patients achieved full donor chimerism, which was more frequently observed in cases presenting cGHVD (p=0.01). These data sustain the relevant role of molecular monitoring in MM patients undergoing NMT. MRD monitoring would assist physicians in making additional therapeutic decisions to better control this hematological malignancy.
Department of Oncology, Transplant and Advances in Medicine, Section of Hematology, University of Pisa, Ospedale S. Chiara-Via Roma, 56-56100 Pisa, Italy. s.galimberti@med.unipi.it
Sara
S
Galimberti
Edoardo
E
Benedetti
Fortunato
F
Morabito
Federico
F
Papineschi
Vincenzo
V
Callea
Rita
R
Fazzi
Caterina
C
Stelitano
Francesca
F
Andreazzoli
Francesca
F
Guerrini
Elena
E
Ciabatti
Massimo
M
Martino
Francesco
F
Nobile
Pasquale
P
Iacopino
Mario
M
Petrini
D000328:Adult; D000368:Aged; D019075:Electrophoresis, Capillary; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000628:therapy*; D018365:Neoplasm, Residual / Q000175:diagnosis* / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D016133:Polymerase Chain Reaction; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous