title: Minimal residual disease in myeloma by flow cytometry: independent prediction of survival benefit per log reduction.
abstract: The detection of minimal residual disease (MRD) in myeloma using a 0.01% threshold (10(-4)) after treatment is an independent predictor of progression-free survival (PFS), but not always of overall survival (OS). However, MRD level is a continuous variable, and the predictive value of the depth of tumor depletion was evaluated in 397 patients treated intensively in the Medical Research Council Myeloma IX study. There was a significant improvement in OS for each log depletion in MRD level (median OS was 1 year for ≥10%, 4 years for 1% to <10%, 5.9 years for 0.1% to <1%, 6.8 years for 0.01% to <0.1%, and more than 7.5 years for <0.01% MRD). MRD level as a continuous variable determined by flow cytometry independently predicts both PFS and OS, with approximately 1 year median OS benefit per log depletion. The trial was registered at www.isrctn.com as #68454111.
authors: St James's University Hospital, Leeds, United Kingdom;
authors: Andy C
authors: AC
authors: Rawstron
authors: University of Leeds, Leeds, United Kingdom;
authors: Walter M
authors: WM
authors: Gregory
authors: St James's University Hospital, Leeds, United Kingdom;
authors: Ruth M
authors: RM
authors: de Tute
authors: Institute of Cancer Research, London, United Kingdom;
authors: Faith E
authors: FE
authors: Davies
authors: University of Leeds, Leeds, United Kingdom;
authors: Sue E
authors: SE
authors: Bell
authors: University of Birmingham, Birmingham, United Kingdom; and.
authors: Mark T
authors: MT
authors: Drayson
authors: St James's University Hospital, Leeds, United Kingdom;
authors: Gordon
authors: G
authors: Cook
authors: University of Newcastle, Newcastle, United Kingdom.
authors: Graham H
authors: GH
authors: Jackson
authors: Institute of Cancer Research, London, United Kingdom;
authors: Gareth J
authors: GJ
authors: Morgan
authors: University of Leeds, Leeds, United Kingdom;
authors: J Anthony
authors: JA
authors: Child
authors: St James's University Hospital, Leeds, United Kingdom;
authors: Roger G
authors: RG
authors: Owen
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D018365:Neoplasm, Residual / Q000175:diagnosis*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012074:Remission Induction; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome
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