title: Evaluation of minimal residual disease in multiple myeloma patients by fluorescent-polymerase chain reaction: the prognostic impact of achieving molecular response.
abstract: This study aimed to standardize a simple molecular method for evaluating the response to treatment in multiple myeloma (MM) patients after high dose chemotherapy. Fifty three patients enrolled in the GEM2000 protocol were studied for minimal residual disease (MRD) using both fluorescent-polymerase chain reaction (F-PCR) and flow cytometry. Most patients had achieved complete remission or very good response after autologous stem cell transplantation. The molecular analysis of immunoglobulin gene rearrangements at diagnosis and during the follow-up was carried out by F-PCR according to the Biomed-2 protocols. F-PCR could be used in 91% of the patients and the results were similar to flow cytometry. F-PCR was able to identify a group of patients with a better prognosis [progression-free survival (PFS) 67.86% in patients with negative F-PCR vs. 28%; P = 0.001], even amongst patients who achieved a complete response with negative immunofixation (PFS 75% vs. 25%; P = 0.002). Multivariate analysis identified the F-PCR result as the only variable to show a prognostic value when PFS was analysed. F-PCR of DHJ and light chain rearrangements of immunoglobulin genes is a feasible method for evaluating MRD in MM patients after intensive therapy. Achieving molecular response by F-PCR shows prognostic value.
authors.affiliation: Servicio de Hematología, Hospital Universitario 12 de Octubre, Madrid, Spain. mpmartinezsa@yahoo.es
authors.forename: Pilar
authors.initials: P
authors.lastname: Martínez-Sánchez
authors.forename: Laura
authors.initials: L
authors.lastname: Montejano
authors.forename: Maria Eugenia
authors.initials: ME
authors.lastname: Sarasquete
authors.forename: Ramón
authors.initials: R
authors.lastname: García-Sanz
authors.forename: Elena
authors.initials: E
authors.lastname: Fernández-Redondo
authors.forename: Rosa
authors.initials: R
authors.lastname: Ayala
authors.forename: María Angeles
authors.initials: MA
authors.lastname: Montalbán
authors.forename: Rafael
authors.initials: R
authors.lastname: Martínez
authors.forename: José
authors.initials: J
authors.lastname: García Laraña
authors.forename: Adrian
authors.initials: A
authors.lastname: Alegre
authors.forename: Belen
authors.initials: B
authors.lastname: Hernández
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Lahuerta
authors.forename: Joaquín
authors.initials: J
authors.lastname: Martínez-López
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005434:Flow Cytometry; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007143:Immunoglobulin Heavy Chains; D007147:Immunoglobulin Light Chains; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000628:therapy; D018365:Neoplasm, Residual; D016133:Polymerase Chain Reaction / Q000379:methods; D011379:Prognosis; D012680:Sensitivity and Specificity
chemical_list: D007143:Immunoglobulin Heavy Chains; D007147:Immunoglobulin Light Chains