Polymerase chain reaction (PCR)-based minimal residual disease (MRD) analysis is a useful prognostic tool in multiple myeloma (MM), although its long-term impact still needs to be addressed. This report presents the updated results of the GIMEMA-VEL-03-096 trial. Thirty-nine MM patients receiving bortezomib-thalidomide-dexamethasone after autologous transplantation were monitored for MRD by both nested and real-time quantitative-PCR until relapse. Our data confirm the strong impact of MRD on survival: overall survival was 72% at 8 years median follow-up for patients in major MRD response versus 48% for those experiencing MRD persistence (P=0.041). In addition, MRD kinetics resulted predictive for relapse: indeed median remission duration was not reached for patients in major MRD response, 38 months for those experiencing MRD reappearance and 9 months for patients with MRD persistence (P<0.001). Moreover: (1) 26 patients achieving major MRD response (67%) benefit of excellent disease control (median TNT: 42 months); (2) MRD reappearance heralds relapse, with a TNT comparable to that of MRD persistence (9 versus 10 months, P=0.706); (3) the median lag between MRD reappearance and need for salvage treatment is 9 months. These results suggest the usefulness of a long-term MRD monitoring in MM patients and the need for maintenance or pre-emptive treatments ensuring durable responses.

Long-term results of the GIMEMA VEL-03-096 trial in MM patients receiving VTD consolidation after ASCT: MRD kinetics' impact on survival

FERRERO, SIMONE
Co-first
;
LADETTO, Marco
Co-first
;
DRANDI, Daniela;CAVALLO, Federica;GENUARDI, ELISA;BOCCADORO, Mario;PALUMBO, Antonio
Last
2015

Abstract

Polymerase chain reaction (PCR)-based minimal residual disease (MRD) analysis is a useful prognostic tool in multiple myeloma (MM), although its long-term impact still needs to be addressed. This report presents the updated results of the GIMEMA-VEL-03-096 trial. Thirty-nine MM patients receiving bortezomib-thalidomide-dexamethasone after autologous transplantation were monitored for MRD by both nested and real-time quantitative-PCR until relapse. Our data confirm the strong impact of MRD on survival: overall survival was 72% at 8 years median follow-up for patients in major MRD response versus 48% for those experiencing MRD persistence (P=0.041). In addition, MRD kinetics resulted predictive for relapse: indeed median remission duration was not reached for patients in major MRD response, 38 months for those experiencing MRD reappearance and 9 months for patients with MRD persistence (P<0.001). Moreover: (1) 26 patients achieving major MRD response (67%) benefit of excellent disease control (median TNT: 42 months); (2) MRD reappearance heralds relapse, with a TNT comparable to that of MRD persistence (9 versus 10 months, P=0.706); (3) the median lag between MRD reappearance and need for salvage treatment is 9 months. These results suggest the usefulness of a long-term MRD monitoring in MM patients and the need for maintenance or pre-emptive treatments ensuring durable responses.
29
3
689
695
http://www.nature.com/leu/index.html
Adult; Aged; Boronic Acids; Bortezomib; Dexamethasone; Female; Follow-Up Studies; Gene Expression; Humans; Immunoglobulin Heavy Chains; Male; Middle Aged; Multiple Myeloma; Neoplasm, Residual; Polymerase Chain Reaction; Pyrazines; Recurrence; Survival Analysis; Thalidomide; Transplantation, Autologous; Antineoplastic Combined Chemotherapy Protocols; Hematopoietic Stem Cell Transplantation; Medicine (all); Hematology; Cancer Research; Anesthesiology and Pain Medicine
S Ferrero;M Ladetto;D Drandi;F Cavallo;E Genuardi;M Urbano;S Caltagirone;M Grasso;F Rossini;T Guglielmelli;C Cangialosi;A M Liberati;V Callea;T Carovita;C Crippa;L De Rosa;F Pisani;A P Falcone;P Pregno;S Oliva;C Terragna;P Musto;R Passera;M Boccadoro;A Palumbo
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/149897
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