Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Commentary
  • Published:

MRD-driven treatment paradigm for newly diagnosed transplant eligible multiple myeloma patients

Bone Marrow Transplantation volume 51, pages 913–914 (2016)Cite this article

Subjects

Minimal residual disease (MRD) testing is increasingly important for the assessment of treatment response in patients diagnosed with multiple myeloma. In fact, MRD negativity is consistently associated with a better PFS and overall survival.1, 2, 3, 4, 5, 6, 7, 8, 9

In this issue of the Journal, Sherrod et al.10 publish a timely review article focusing on MRD testing after stem cell transplantation for patients with multiple myeloma. They review and discuss novel biochemical assays (including serum-free light-chain assays and heavy-chain/light-chain assays) as well as novel methods to measure MRD, including multi-parametric flow cytometry, PCR, next-generation sequencing and functional imaging modalities. They outline the main literature on this topic and highlight on the strengths and weaknesses of each of these assays and approaches. Furthermore, they address practical questions related to MRD testing after stem cell transplantation for patients with multiple myeloma. As part of their conclusion, they point out the clear need for International Myeloma Working Group response criteria to be revised and updated to include MRD.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

References

  1. Durie BG, Harousseau JL, Miguel JS, Blade J, Barlogie B, Anderson K et al. International uniform response criteria for multiple myeloma. Leukemia 2006; 20: 1467–1473.

    Article  CAS  Google Scholar 

  2. San Miguel JF, Almeida J, Mateo G, Blade J, Lopez-Berges C, Caballero D et al. Immunophenotypic evaluation of the plasma cell compartment in multiple myeloma: a tool for comparing the efficacy of different treatment strategies and predicting outcome. Blood 2002; 99: 1853–1856.

    Article  Google Scholar 

  3. Rawstron AC, Davies FE, DasGupta R, Ashcroft AJ, Patmore R, Drayson MT et al. Flow cytometric disease monitoring in multiple myeloma: the relationship between normal and neoplastic plasma cells predicts outcome after transplantation. Blood 2002; 100: 3095–3100.

    Article  CAS  Google Scholar 

  4. Rawstron AC, Child JA, de Tute RM, Davies FE, Gregory WM, Bell SE et al. Minimal residual disease assessed by multiparameter flow cytometry in multiple myeloma: impact on outcome in the Medical Research Council Myeloma IX Study. J Clin Oncol 2013; 31: 2540–2547.

    Article  Google Scholar 

  5. Paiva B, Vidriales MB, Cervero J, Mateo G, Perez JJ, Montalban MA et al. Multiparameter flow cytometric remission is the most relevant prognostic factor for multiple myeloma patients who undergo autologous stem cell transplantation. Blood 2008; 112: 4017–4023.

    Article  CAS  Google Scholar 

  6. Paiva B, Martinez-Lopez J, Vidriales MB, Mateos MV, Montalban MA, Fernandez-Redondo E et al. Comparison of immunofixation, serum free light chain, and immunophenotyping for response evaluation and prognostication in multiple myeloma. J Clin Oncol 2011; 29: 1627–1633.

    Article  CAS  Google Scholar 

  7. Paiva B, Gutierrez NC, Rosinol L, Vidriales MB, Montalban MA, Martinez-Lopez J et al. High-risk cytogenetics and persistent minimal residual disease by multiparameter flow cytometry predict unsustained complete response after autologous stem cell transplantation in multiple myeloma. Blood 2012; 119: 687–691.

    Article  CAS  Google Scholar 

  8. Korde N, Roschewski M, Zingone A, Kwok M, Manasanch EE, Bhutani M et al. Treatment With Carfilzomib-Lenalidomide-Dexamethasone With Lenalidomide Extension in Patients With Smoldering or Newly Diagnosed Multiple Myeloma. JAMA oncology 2015; 1: 746–754.

    Article  Google Scholar 

  9. Mailankody S, Korde N, Lesokhin AM, Lendvai N, Hassoun H, Stetler-Stevenson M et al. Minimal residual disease in multiple myeloma: bringing the bench to the bedside. Nat Rev Clin Oncol 2015; 12: 286–295.

    Article  Google Scholar 

  10. Sherrod AM, Hari P, Mosse CA, Walker RC, Cornell RF . Minimal residual disease testing after stem cell transplantation for multiple myeloma. Bone Marrow Transplant 2016; 51: 2–12.

    Article  CAS  Google Scholar 

  11. Attal M . Autologous transplantation for multiple myeloma in the era of new drugs: a phase iii study of the Intergroupe Francophone Du Myelome (IFM/DFCI 2009 Trial). Blood 2015; 126: 391.

    Google Scholar 

  12. Avet-Loiseau H . Evaluation of minimal residual disease (MRD) by next generation sequencing (NGS) is highly predictive of progression free survival in the IFM/DFCI 2009 trial. Blood 2015; 126: 191.

    Google Scholar 

  13. Landgren O, Owen RG . Better therapy requires better response evaluation: paving the way for minimal residual disease testing for every myeloma patient. Cytometry B Clin Cytom 2015; 90: 14–20.

    Article  Google Scholar 

  14. Rawstron AC, Gregory WM, de Tute RM, Davies FE, Bell SE, Drayson MT et al. Minimal residual disease in myeloma by flow cytometry: independent prediction of survival benefit per log reduction. Blood 2015; 125: 1932–1935.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Myeloma Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    O Landgren

  2. Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    S Giralt

Authors
  1. O Landgren
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S Giralt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to O Landgren.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Landgren, O., Giralt, S. MRD-driven treatment paradigm for newly diagnosed transplant eligible multiple myeloma patients. Bone Marrow Transplant 51, 913–914 (2016). https://doi.org/10.1038/bmt.2016.24

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2016.24

This article is cited by

Search

Advanced search

Quick links