title: Multiple myeloma in serologic complete remission after autologous stem cell transplantation: impact of bone marrow plasma cell assessment by conventional morphology on disease progression.
abstract: The current definition of complete remission (CR) in multiple myeloma (MM) requires a negative serum and urine immunofixation (IFE) and <5% bone marrow plasma cells (BMPCs). The aim of this study was to determine the value of BMPCs count by standard microscopic evaluation in patients with MM in serologic CR after autologous stem cell transplantation (ASCT). Thirty-five patients with a median follow-up after ASCT of 7.3 years were studied. The percentage of BMPCs was an independent predictor of progression in multivariate model (hazard ratio 2.02, P = .009). Patients with >1.5% BMPCs (median: 0.8%) after ASCT had an increased risk of progression (P = .016) and a trend toward a shorter survival (P = .195). In conclusion, conventional morphology of bone marrow is a useful and rapid tool as a first step to assess the residual tumor mass in patients with MM in CR after ASCT, and it constitutes a strong predictor for disease progression.
authors.affiliation: Department of Hematology, Hospital Clínic, Barcelona. Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernández de Larrea
authors.forename: Natalia
authors.initials: N
authors.lastname: Tovar
authors.forename: María
authors.initials: M
authors.lastname: Rozman
authors.forename: Laura
authors.initials: L
authors.lastname: Rosiñol
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Aróstegui
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Cibeira
authors.forename: Montserrat
authors.initials: M
authors.lastname: Rovira
authors.forename: Jordi
authors.initials: J
authors.lastname: Yagüe
authors.forename: Joan
authors.initials: J
authors.lastname: Bladé
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology*; D001856:Bone Marrow Examination / Q000379:methods*; D002066:Busulfan / Q000008:administration & dosage; D002452:Cell Count; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D018365:Neoplasm, Residual; D036102:Peripheral Blood Stem Cell Transplantation; D010950:Plasma Cells / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D012074:Remission Induction; D012307:Risk Factors; D012680:Sensitivity and Specificity; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous; D014916:Whole-Body Irradiation
chemical_list: D002066:Busulfan; D008558:Melphalan