title: Minimal residual disease in multiple myeloma: bringing the bench to the bedside.
abstract: Outcomes for patients with multiple myeloma (MM) have improved substantially in the past decade, with improvements in both progression-free survival and overall survival. Many patients are now achieving a complete response to treatment, and consequently highly sensitive assays are needed for detection of minimal residual disease (MRD) in patients with MM. Results of multicolour flow cytometry and deep-sequencing studies suggest that among patients achieving a complete response, MRD-negative status is associated with significant improvements in progression-free survival and overall survival. Despite the increasing need for MRD testing in patients with MM, considerable heterogeneity in techniques for MRD detection hinders the clinical interpretation of their results. The criteria used to define MRD, strengths and weaknesses of the major types of tests (flow cytometry versus molecular testing), and the optimal sample type (bone marrow aspirate versus peripheral blood) are all unresolved dilemmas in MRD testing. This Review presents an overview of the various techniques for MRD detection in patients with MM. In addition, this article discusses challenges and opportunities for the routine use of MRD testing, possible future directions for clinical trials and implications for drug approval processes.
authors.affiliation: Multiple Myeloma Section, Lymphoid Malignancies Branch, Centre for Cancer Research, National Institutes of Health, National Cancer Institute, 9000 Rockville Pike, Bethesda, MD 20892, USA.
authors.forename: Sham
authors.initials: S
authors.lastname: Mailankody
authors.affiliation: Myeloma Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
authors.forename: Neha
authors.initials: N
authors.lastname: Korde
authors.affiliation: Myeloma Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Lesokhin
authors.affiliation: Myeloma Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
authors.forename: Nikoletta
authors.initials: N
authors.lastname: Lendvai
authors.affiliation: Myeloma Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
authors.forename: Hani
authors.initials: H
authors.lastname: Hassoun
authors.affiliation: Flow Cytometry Laboratory, Laboratory of Pathology, National Institutes of Health, National Cancer Institute, 9000 Rockville Pike, Bethesda, MD 20892, USA.
authors.forename: Maryalice
authors.initials: M
authors.lastname: Stetler-Stevenson
authors.affiliation: Myeloma Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
authors.forename: Ola
authors.initials: O
authors.lastname: Landgren
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005434:Flow Cytometry / Q000379:methods; D005821:Genetic Techniques; D006801:Humans; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D018365:Neoplasm, Residual; D016133:Polymerase Chain Reaction / Q000379:methods; D057170:Translational Research, Biomedical / Q000379:methods