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Prashant Kapoor, MD, FACP


Standard Marrow Versus MRD Testing: Guiding Treatment Decisions in Myeloma

By: Joshua D. Madera, MD
Posted: Monday, September 25, 2023

The vast number of treatment options for patients with multiple myeloma has increased the complexity of decision-making for physicians, suggested Rahul Banerjee, MD, of the University of Washington, Seattle, and colleagues. Of 75 physicians surveyed, many of whom practiced in a community setting, most primarily used conventional karyotyping of fluorescent in situ hybridization (FISH) to guide treatment decisions, with measurable residual disease (MRD) assessments ordered in just one-third of cases. These findings, which were presented at the 2023 Society of Hematologic Oncology (SOHO) Annual Meeting (Abstract MM-290) and published in Clinical Lymphoma, Myeloma, and Leukemia Congress, suggest a need to establish a clear protocol to help physicians treat their patients with multiple myeloma, the investigators noted.

A total of 75 board-certified hematologists and/or oncologists completed an online survey assessing their opinions regarding diagnostic strategies to guide treatment in patients with multiple myeloma. All recruited physicians had managed at least ten patients with multiple myeloma, had been practicing for at least 2 years, and spent more than 50% of their clinical practice time in the United States.

The study analyses revealed that bone marrow karyotyping and FISH studies were ordered significantly more frequently (77.8%) than MRD assessments (41.3%). Karyotyping and FISH diagnostic analyses impacted treatment strategies in 53.3% of cases, whereas MRD analyses guided them in 39.4% of cases.

In addition, physicians were asked to rate their agreeableness on different statements regarding treatments and patient counseling. The authors found that personalized treatments were slightly more favorable than standardized treatments. Furthermore, there was an increased emphasis on the importance of educating patients regarding the way their disease will respond to treatment and information about disease progression.

Disclosure: The study authors reported no conflicts of interest.

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