Posted: Wednesday, August 7, 2024
Based on the results of a study published in the journal HemaSphere, baseline circulating tumor plasma cell and peripheral blood measurable residual disease (MRD) assessment using a highly sensitive multicolor flow cytometry assay seems to be feasible in most newly diagnosed patients with multiple myeloma. Prashant R. Tembhare, MD, of the Homi Bhabha National Institute, Mumbai, India, and colleagues noted this method provides a relevant noninvasive biomarker.
“Negative peripheral blood MRD status strongly indicates better survival,” the investigators remarked. “Sequential peripheral blood MRD monitoring has great potential to improve the impact of the existing risk stratification and response assessment models.”
The investigators focused on 141 patients who were treated with a bortezomib-based triplet regimen and not planned for upfront autologous stem cell transplantation. Using a highly sensitive multicolor flow cytometry assay, they processed peripheral blood for circulating tumor plasma cell quantitation. Peripheral blood MRD was monitored after three and six cycles of chemotherapy in patients with detectable circulating tumor plasma cell levels at baseline.
Based on a multivariate analysis, among baseline risk factors, circulating tumor plasma cell levels of at least 0.01% were independently associated with poor progression-free (hazard ratio [HR] = 2.77; P = .0047) and overall (HR = 2.90; P = .023) survival. In patients with detectable levels of circulating tumor plasma cells at baseline, undetectable peripheral blood MRD at both subsequent time points was found to be associated with prolonged durations of progression-free survival (HR = 0.46; P = .0037), whereas detectable peripheral blood MRD at any time point was reportedly associated with short durations of overall survival (HR = 3.25; P = .004).
According to the investigators, undetectable combined peripheral blood MRD (after three and six cycles) outperformed the serum immunofixation–based response. A multivariate analysis revealed that detectable peripheral blood MRD at any time point independently predicted poor progression-free (HR = 2.00; P = .025) and overall (HR = 3.97; P = .013) survival.
Disclosure: The study authors reported no conflicts of interest.
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