Acta haematologica · 2025
Minimal Clonal Plasma Cell Contamination of Peripheral Stem Cell Grafts Has an Adverse Prognostic Impact in Patients with Multiple Myeloma Undergoing Autologous Transplantation.
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Liu Yang, Shao Danyang, Chang Yingjun, Wang Yazhe, Dou Xuelin, Peng Nan, Wen Lei, Wang Fengrong, Huang Xiaojun, Mo Xiaodong, Lu Jin
Аннотация
INTRODUCTION: The significance of autografts' contamination by clonal plasma cells on clinical outcome in newly diagnosed multiple myeloma (NDMM) remains controversial.
METHODS: We retrospectively reviewed the clinical and laboratory data of NDMM patients who underwent autologous stem cell transplantation (ASCT) and had received graft minimal residual disease (gMRD) examination by multi-color flow cytometry.
RESULTS: From January 2011 to December 2022, 250 NDMM patients with complete cytogenetic information, gMRD information, and who received ASCT as consolidation were enrolled. Multi-flow cytometry can achieve a median detection sensitivity of 0.004%, and gMRD positivity was 12.4% at a median level of 0.0160% (interquartile range, 0.0049%, 0.05394%). Its presence was correlated with response to induction treatment, with percentages of 2.65%, 12.94%, 28.89%, and 57.14% of patients achieving complete response, very good partial response, partial response, and minimal response/stable disease, respectively. gMRD (+) patients had a higher risk of not achieving bone marrow MRD negativity post-ASCT. After a median follow-up of 33.5 months for the whole cohort, patients in the gMRD (+) group had significantly worse progression-free survival (PFS) than those in the gMRD (-) group did (34.8 vs. 65.0 months, p = 0.001). Multivariable analysis revealed that gMRD (-) was independently predictive of better PFS (hazard ratio 0.464, 95% confidence interval: 0.274-0.785, p = 0.004). We found the significance of gMRD on PFS was in high-risk subgroups and in patients who achieved ≤ partial response prior to ASCT.
CONCLUSIONS: In conclusion, gMRD (+) was an independent risk factor for inferior progression-free survival, with the impact primarily affecting high-risk groups and patients who achieved ≤ partial response before ASCT.
METHODS: We retrospectively reviewed the clinical and laboratory data of NDMM patients who underwent autologous stem cell transplantation (ASCT) and had received graft minimal residual disease (gMRD) examination by multi-color flow cytometry.
RESULTS: From January 2011 to December 2022, 250 NDMM patients with complete cytogenetic information, gMRD information, and who received ASCT as consolidation were enrolled. Multi-flow cytometry can achieve a median detection sensitivity of 0.004%, and gMRD positivity was 12.4% at a median level of 0.0160% (interquartile range, 0.0049%, 0.05394%). Its presence was correlated with response to induction treatment, with percentages of 2.65%, 12.94%, 28.89%, and 57.14% of patients achieving complete response, very good partial response, partial response, and minimal response/stable disease, respectively. gMRD (+) patients had a higher risk of not achieving bone marrow MRD negativity post-ASCT. After a median follow-up of 33.5 months for the whole cohort, patients in the gMRD (+) group had significantly worse progression-free survival (PFS) than those in the gMRD (-) group did (34.8 vs. 65.0 months, p = 0.001). Multivariable analysis revealed that gMRD (-) was independently predictive of better PFS (hazard ratio 0.464, 95% confidence interval: 0.274-0.785, p = 0.004). We found the significance of gMRD on PFS was in high-risk subgroups and in patients who achieved ≤ partial response prior to ASCT.
CONCLUSIONS: In conclusion, gMRD (+) was an independent risk factor for inferior progression-free survival, with the impact primarily affecting high-risk groups and patients who achieved ≤ partial response before ASCT.