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ARTÍCULO

High-risk cytogenetics and persistent minimal residual disease by multiparameter flow cytometry predict unsustained complete response after autologous stem cell transplantation in multiple myeloma

Autores: Paiva, Bruno; Gutierrez, N. C.; Rosiñol, L.; Vidriales, M. B.; Montalban, M. A.; Martínez-López, J.; Mateos, M. V.; Cibeira, M. T.; Cordón, L.; Oriol, A.; Terol, M. J.; Echeveste, M. A.; de Paz, R.; de Arriba, F.; Palomera, L.; de la Rubia, J.; Diaz-Mediavilla, J.; Sureda, A.; Gorosquieta, A.; Alegre, A.; Martin, A.; Hernandez, M. T.; Lahuerta, J. J.; Bladè, J.; San Miguel Izquierdo, Jesús; PETHEMA/GEM Cooperative Study Groups
Título de la revista: BLOOD
ISSN: 0006-4971
Volumen: 119
Número: 3
Páginas: 687 - 691
Fecha de publicación: 2012
Resumen:
The achievement of complete response (CR) after high-dose therapy/autologous stem cell transplantation (HDT/ASCT) is a surrogate for prolonged survival in multiple myeloma; however, patients who lose their CR status within 1 year of HDT/ASCT (unsustained CR) have poor prognosis. Thus, the identification of these patients is highly relevant. Here, we investigate which prognostic markers can predict unsustained CR in a series of 241 patients in CR at day +100 after HDT/ASCT who were enrolled in the Spanish GEM2000 (n = 140) and GEM2005 < 65y (n = 101) trials. Twenty-nine (12%) of the 241 patients showed unsustained CR and a dismal outcome (median overall survival 39 months). The presence of baseline high-risk cytogenetics by FISH (hazard ratio 17.3; P = .002) and persistent minimal residual disease by multiparameter flow cytometry at day +100 after HDT/ASCT (hazard ratio 8.0; P = .005) were the only independent factors that predicted unsustained CR. Thus, these 2 parameters may help to identify patients in CR at risk of early progression after HDT/ASCT in whom novel treatments should be investigated.
DOI: https://doi.org/10.1182/blood-2011-07-370460
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