EHA25 Virtual: Deauville Score Criteria and Minimal Residual Disease in Myeloma
Posted: Wednesday, July 8, 2020
According to findings from the phase II FORTE trial, presented during the virtual edition of the 25th Annual European Hematology Association (EHA) Annual Congress (EHA25 Virtual; Abstract S207), PET/CT scans met Deauville Score criteria for defining minimal residual disease (MRD) status outside bone marrow in patients with multiple myeloma. Elena Zamagni MD, PhD, of the European Myeloma Network, Rome, and colleagues found that negative PET and CT results correlated with the best complete response rates in newly diagnosed study patients who were eligible for transplantation.
“Future analyses will show the impact of PET/CT compared to bone marrow MRD techniques on patients’ outcomes,” the authors noted.
A total of 474 patients with newly diagnosed multiple myeloma who were eligible for transplantation were enrolled. The authors evaluated MRD by performing eight-color second-generation flow cytometry in patients who achieved at least a very good partial response. In cases of complete response or better, MRD premaintenance was also assessed by next-generation sequencing, and PET/CT scans were performed locally at baseline and before maintenance.
In total, 182 patients had a matched PET or CT and multiparameter flow cytometry evaluation and were included in the analysis. At baseline, 92% of patients had focal lesions. Focal lesions and bone marrow uptake of at least four were present in 87% and 59% of patients, respectively. At preceding maintenance, PET or CT negativity at Deauville Scores less than 4 was seen in 78% of focal lesions and 85% in the bone marrow.
The authors noted a “strong” concordance between MRD results and PET or CT bone marrow uptake and multiparameter flow cytometry. The two techniques were concordant in 94% of cases, compared with 63% in focal lesions and multiparameter flow cytometry. Conversely, PET and next-generation sequencing data available for 65 patients showed a “moderate” concordance of 84% between PET/CT bone marrow uptake and next-generation sequencing and 67% between focal lesions and next-generation sequencing.
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