title: High-risk cytogenetics and persistent minimal residual disease by multiparameter flow cytometry predict unsustained complete response after autologous stem cell transplantation in multiple myeloma.
abstract: The achievement of complete response (CR) after high-dose therapy/autologous stem cell transplantation (HDT/ASCT) is a surrogate for prolonged survival in multiple myeloma; however, patients who lose their CR status within 1 year of HDT/ASCT (unsustained CR) have poor prognosis. Thus, the identification of these patients is highly relevant. Here, we investigate which prognostic markers can predict unsustained CR in a series of 241 patients in CR at day +100 after HDT/ASCT who were enrolled in the Spanish GEM2000 (n = 140) and GEM2005 < 65y (n = 101) trials. Twenty-nine (12%) of the 241 patients showed unsustained CR and a dismal outcome (median overall survival 39 months). The presence of baseline high-risk cytogenetics by FISH (hazard ratio 17.3; P = .002) and persistent minimal residual disease by multiparameter flow cytometry at day +100 after HDT/ASCT (hazard ratio 8.0; P = .005) were the only independent factors that predicted unsustained CR. Thus, these 2 parameters may help to identify patients in CR at risk of early progression after HDT/ASCT in whom novel treatments should be investigated.
authors: Hospital Universitario de Salamanca, Spain.
authors: Bruno
authors: B
authors: Paiva
authors: Norma C
authors: NC
authors: Gutiérrez
authors: Laura
authors: L
authors: Rosiñol
authors: María-Belén
authors: MB
authors: Vídriales
authors: María-Ángeles
authors: MÁ
authors: Montalbán
authors: Joaquín
authors: J
authors: Martínez-López
authors: María-Victoria
authors: MV
authors: Mateos
authors: María-Teresa
authors: MT
authors: Cibeira
authors: Lourdes
authors: L
authors: Cordón
authors: Albert
authors: A
authors: Oriol
authors: María-José
authors: MJ
authors: Terol
authors: María-Asunción
authors: MA
authors: Echeveste
authors: Raquel
authors: R
authors: de Paz
authors: Felipe
authors: F
authors: de Arriba
authors: Luis
authors: L
authors: Palomera
authors: Javier
authors: J
authors: de la Rubia
authors: Joaquín
authors: J
authors: Díaz-Mediavilla
authors: Anna
authors: A
authors: Sureda
authors: Ana
authors: A
authors: Gorosquieta
authors: Adrian
authors: A
authors: Alegre
authors: Alejandro
authors: A
authors: Martin
authors: Miguel T
authors: MT
authors: Hernández
authors: Juan-José
authors: JJ
authors: Lahuerta
authors: Joan
authors: J
authors: Bladé
authors: Jesús F
authors: JF
authors: San Miguel
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D003131:Combined Modality Therapy; D020732:Cytogenetic Analysis; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000628:therapy*; D018365:Neoplasm, Residual / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality; D012074:Remission Induction; D012307:Risk Factors; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D015996:Survival Rate; D014182:Transplantation, Autologous; D016896:Treatment Outcome