title: Controversies in the assessment of minimal residual disease in multiple myeloma: clinical significance of minimal residual disease negativity using highly sensitive techniques.
abstract: Minimal residual disease (MRD) assessment has gained importance in the response evaluation of multiple myeloma. As discussed in part 1 of this two-part series, techniques such as multiparameter flow cytometry, polymerase chain reaction, and next-generation sequencing, of both bone marrow and peripheral blood, have the potential to achieve a high level of sensitivity, up to 1 in 10(-6) cells, enabling analysis of genetically diverse subclones. Here, we review the clinical utility of MRD assessment using these techniques. Specifically, we review the association between MRD-negativity and progression-free or overall survival in various clinical settings (post-induction, post-auto or allo-stem cell transplant, transplant ineligible, maintenance, and relapsed/refractory). Currently, the goal of assessing MRD in multiple myeloma (MM) is to allow for a risk-stratified approach to therapy and for earlier identification of response to novel agents, particularly in the setting of clinical trials.
authors.affiliation: John Theurer Cancer Center, Hackensack University Medical Center, 92 Second Street, Suite 340, Hackensack, NJ, 07601, USA, NBiran@hackensackumc.org.
authors.forename: Noa
authors.initials: N
authors.lastname: Biran
authors.forename: Scott
authors.initials: S
authors.lastname: Ely
authors.forename: Ajai
authors.initials: A
authors.lastname: Chari
mesh_terms: D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D009101:Multiple Myeloma / Q000188:drug therapy; D018365:Neoplasm, Residual / Q000628:therapy*; D014182:Transplantation, Autologous / Q000379:methods*