Detalle Publicación

Clinical applicability and prognostic significance of molecular response assessed by fluorescent-PCR of immunoglobulin genes in multiple myeloma. Results from a GEM/PETHEMA study

Autores: Martínez-López, J.; Fernandez-Redondo, E.; Garcia-Sanz, R.; Montalban, M. A.; Martinez-Sanchez, P.; Paiva, Bruno; Mateos, M. V.; Rosiñol, L.; Martin, M.; Ayala, R.; Martínez, R.; Blanchard, M. J.; Alegre, A.; Besalduch, J.; Bargay, J.; Hernandez, M. T.; Sarasquete, M. E.; Sanchez-Godoy, P.; Fernandez, M.; Bladè, J.; San Miguel Izquierdo, Jesús; Lahuerta, J. J.; GEM/PETHEMA cooperative study group
ISSN: 1365-2141
Volumen: 163
Número: 5
Páginas: 581 - 589
Fecha de publicación: 2013
Minimal residual disease monitoring is becoming increasingly important in multiple myeloma (MM), but multiparameter flow cytometry (MFC) and allele-specific oligonucleotide polymerase chain reaction (ASO-PCR) techniques are not routinely available. This study investigated the prognostic influence of achieving molecular response assessed by fluorescent-PCR (F-PCR) in 130 newly diagnosed MM patients from Grupo Espanol Multidisciplinar de Melanoma (GEM)2000/GEM05 trials (NCT00560053, NCT00443235, NCT00464217) who achieved almost very good partial response after induction therapy. As a reference, we used the results observed with simultaneous MFC. F-PCR at diagnosis was performed on DNA using three different multiplex PCRs: IGH D-J, IGK V-J and KDE rearrangements. The applicability of F-PCR was 915%. After induction therapy, 64 patients achieved molecular response and 66 non-molecular response; median progression-free survival (PFS) was 61 versus 36months, respectively (P=0001). Median overall survival (OS) was not reached (NR) in molecular response patients (5-year survival: 75%) versus 66months in the non-molecular response group (P=003). The corresponding PFS and OS values for patients with immunophenotypic versus non-immunophenotypic response were 67 versus 42months (P=0005) and NR (5-year survival: 95%) versus 69months (P=0004), respectively. F-PCR analysis is a rapid, affordable, and easily performable technique that, in some circumstances, may be a valid approach for minimal residual disease investigations in MM.