Detalle Publicación

Prognostic value of deep sequencing method for minimal residual disease detection in multiple myeloma

Autores: Martínez-López, J.; Lahuerta, J. J.; Pepin, F.; Gonzalez, M.; Barrio, S.; Ayala, R.; Puig, N.; Montalban, M. A.; Paiva, Bruno; Weng, L.; Jimenez, C.; Sopena, M.; Moorhead, M.; Cedena, T.; Rapado, I.; Victoria Mateos, M.; Rosiñol, L.; Oriol, A.; Blanchard, M. J.; Martínez, R.; Bladè, J.; San Miguel Izquierdo, Jesús; Faham, M.; Gracia-sanz, R.
Título de la revista: BLOOD
ISSN: 0006-4971
Volumen: 123
Número: 20
Páginas: 3073 - 3079
Fecha de publicación: 2014
We assessed the prognostic value of minimal residual disease(MRD) detection in multiple myeloma(MM) patients using a sequencing-based platform in bone marrow samples from 133 MM patients in at least very good partial response (VGPR) after front-line therapy. Deep sequencing was carried out in patients in whom a high-frequency myeloma clone was identified and MRD was assessed using the IGH-VDJ(H), IGH-DJ(H), and IGK assays. The results were contrasted with those of multiparametric flow cytometry (MFC) and allele-specific oligonucleotide polymerase chain reaction (ASO-PCR). The applicability of deep sequencing was 91%. Concordance between sequencing and MFC and ASO-PCR was 83% and 85%, respectively. Patients who were MRD- by sequencing had a significantly longer time to tumor progression (TTP) (median 80 vs 31 months; P < .0001) and overall survival (median not reached vs 81 months; P = .02), compared with patients who were MRD+. When stratifying patients by different levels of MRD, the respective TTP medians were: MRD >= 10(-3) 27 months, MRD 10(-3) to 10(-5) 48 months, and MRD <10(-5) 80 months (P = .003 to .0001). Ninety-two percent of VGPR patients were MRD+. In complete response patients, the TTP remained significantly longer for MRD- compared with MRD+ patients (131 vs 35 months; P = .0009).