Minimal residual disease (MRD) by multiparameter flow cytometry (MFC) is the most effective tool to define a deep response in multiple myeloma (MM). We conducted an MRD correlative study of the EMN02/HO95 MM phase III trial in newly diagnosed MM patients achieving a suspected complete response before maintenance and every 6 months during maintenance. Patients received high-dose melphalan (HDM) versus bortezomib-melphalan-prednisone (VMP) intensification, followed by bortezomib-lenalidomide-dexamethasone (VRd) versus no consolidation, and lenalidomide maintenance. Bone marrow (BM) samples were processed in three European laboratories, applying EuroFlow-based MFC protocols (eight colors, two tubes) with 10(-4)-10(-5) sensitivity. At enrollment in the MRD correlative study, 76% (244/321) of patients were MRD-negative. In the intention-to-treat analysis, after a median follow-up of 75 months, 5-year progression-free survival was 66% in MRD-negative versus 31% in MRD-positive patients (HR 0.39; p < 0.001), 5-year overall survival was 86% versus 69%, respectively (HR 0.41; p < 0.001). MRD negativity was associated with reduced risk of progression or death in all subgroups, including ISS-III (HR 0.37) and high-risk fluorescence in situ hybridization (FISH) patients (HR 0.38;). In the 1-year maintenance MRD population, 42% of MRD-positive patients at pre-maintenance became MRD-negative after lenalidomide exposure. In conclusion, MRD by MFC is a strong prognostic factor. Lenalidomide maintenance further improved MRD-negativity rate.

Minimal residual disease assessment by multiparameter flow cytometry in transplant-eligible myeloma in the EMN02/HOVON 95 MM trial

Oliva, Stefania
Co-first
;
D'Agostino, Mattia;Capra, Andrea;Troia, Rossella;Villanova, Tania;Gay, Francesca;Boccadoro, Mario;
2021-01-01

Abstract

Minimal residual disease (MRD) by multiparameter flow cytometry (MFC) is the most effective tool to define a deep response in multiple myeloma (MM). We conducted an MRD correlative study of the EMN02/HO95 MM phase III trial in newly diagnosed MM patients achieving a suspected complete response before maintenance and every 6 months during maintenance. Patients received high-dose melphalan (HDM) versus bortezomib-melphalan-prednisone (VMP) intensification, followed by bortezomib-lenalidomide-dexamethasone (VRd) versus no consolidation, and lenalidomide maintenance. Bone marrow (BM) samples were processed in three European laboratories, applying EuroFlow-based MFC protocols (eight colors, two tubes) with 10(-4)-10(-5) sensitivity. At enrollment in the MRD correlative study, 76% (244/321) of patients were MRD-negative. In the intention-to-treat analysis, after a median follow-up of 75 months, 5-year progression-free survival was 66% in MRD-negative versus 31% in MRD-positive patients (HR 0.39; p < 0.001), 5-year overall survival was 86% versus 69%, respectively (HR 0.41; p < 0.001). MRD negativity was associated with reduced risk of progression or death in all subgroups, including ISS-III (HR 0.37) and high-risk fluorescence in situ hybridization (FISH) patients (HR 0.38;). In the 1-year maintenance MRD population, 42% of MRD-positive patients at pre-maintenance became MRD-negative after lenalidomide exposure. In conclusion, MRD by MFC is a strong prognostic factor. Lenalidomide maintenance further improved MRD-negativity rate.
2021
11
6
106
N/A
https://www.nature.com/articles/s41408-021-00498-0
https://doi.org/10.1038/s41408-021-00498-0
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8175611/
Oliva, Stefania; Hofste op Bruinink, Davine; Rihova, Lucie; D'Agostino, Mattia; Pantani, Lucia; Capra, Andrea; van der Holt, Bronno; Troia, Rossella; ...espandi
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Descrizione: [PUBLISHED Vsn.] Oliva S, Hofste Op Bruinink D, et al. Blood Cancer J. 2021 Jun 3;11(6):106. doi: 10.1038/s41408-021-00498-0. PMID: 34083504; PMCID: PMC8175611. © The Author(s) 2021. Available at: https://www.nature.com/articles/s41408-021-00498-0 | https://doi.org/10.1038/s41408-021-00498-0 | http://www.ncbi.nlm.nih.gov/pmc/articles/pmc8175611/
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/1790999
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