title: Assessment of minimal residual disease in myeloma and the need for a consensus approach.
abstract: Treatment options for myeloma continue to develop at a rapid pace, and it is becoming increasingly challenging to determine the optimal therapeutic approaches because demonstrating a clear survival benefit now requires many years of follow-up. The detection of minimal residual disease (MRD) is recognized as a sensitive and rapid approach to evaluate treatment efficacy that predicts progression-free and overall survival independent of categorical response assessment and patients' biology. The benefit of MRD analysis is reflected in the many different techniques (multiparameter flow cytometry, quantitative polymerase chain reaction, and high-throughput sequencing) and collaborative groups (including EMN, ESCCA, ICCS, EuroFlow, and EuroMRD) that have performed collaborative projects to harmonize quantitative MRD detection. The time has come to adopt a consensus approach, and this report reviews the benefits and disadvantages of different strategies for MRD detection in myeloma and highlights the requirements for a sensitive, reproducible, and clinically meaningful cellular analytical approach.
authors.affiliation: HMDS, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom; and On Behalf of the European Society for Clinical Cell Analysis (ESCCA).
authors.forename: Andy C
authors.initials: AC
authors.lastname: Rawstron
authors.affiliation: Clínica Universidad de Navarra, Pamplona, Spain.|Centro de Investigación Médica Aplicada (CIMA), Pamplona, Spain.|Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
authors.forename: Bruno
authors.initials: B
authors.lastname: Paiva
authors.affiliation: Laboratory of Pathology, NCI, Bethesda, Maryland, 20892.
authors.forename: Maryalice
authors.initials: M
authors.lastname: Stetler-Stevenson
mesh_terms: D015703:Antigens, CD / Q000032:analysis* / Q000235:genetics / Q000276:immunology; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols; D032921:Consensus; D005434:Flow Cytometry; D015870:Gene Expression; D018380:Hematopoietic Stem Cell Transplantation; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics / Q000276:immunology; D009101:Multiple Myeloma / Q000175:diagnosis / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D018365:Neoplasm, Residual / Q000175:diagnosis / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D010950:Plasma Cells / Q000187:drug effects / Q000473:pathology; D011110:Polymorphism, Genetic / Q000276:immunology; D011379:Prognosis; D060888:Real-Time Polymerase Chain Reaction; D012074:Remission Induction; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D015703:Antigens, CD; D000970:Antineoplastic Agents; D007143:Immunoglobulin Heavy Chains
keywords: PCR; flow cytometry; high throughput sequencing; minimal residual disease; plasma cell myeloma; quantification; rare event detection