PMID- 30945330
OWN - NLM
STAT- MEDLINE
DCOM- 20200310
LR  - 20200310
IS  - 1096-8652 (Electronic)
IS  - 0361-8609 (Linking)
VI  - 94
IP  - 7
DP  - 2019 Jul
TI  - Prognostic value of minimal residual disease and polyclonal plasma cells in 
      myeloma patients achieving a complete response to therapy.
PG  - 751-756
LID - 10.1002/ajh.25481 [doi]
AB  - Achievement of a complete response has been associated with improved outcomes in 
      patients with multiple myeloma. Recently, increasing application of minimal 
      residual disease (MRD) assessment has shown that MRD negativity is a powerful 
      prognostic factor for survival outcomes. We wanted to examine the impact of the 
      polyclonal plasma cell (pPC) compartment among patients in complete response (CR) 
      but are MRD positive. This is a retrospective cohort study where 460 myeloma 
      patients were identified who met criteria for CR and had multicolor flow 
      cytometry performed on the bone marrow (BM). Monoclonal and pPCs were estimated 
      during MRD testing. Final outcomes including overall survival (OS) and time to 
      next treatment (TTNT) were compared among the groups. The median OS for the 
      entire cohort was not reached (95% CI; 63 mos, NR) and the median TTNT was 31 
      months (95% CI; 27,36). Among the MRD(neg) group, median TTNT was 37.6 months vs 
      23 months for MRD(pos) patients (P < .001); the median OS was not reached for 
      either group, but there was a trend toward better survival for MRD(neg) patients. 
      Among the MRD(pos) group, median percentage of pPCs was 65% (2.5-98.5), and those 
      with >95% pPCs had a significantly better TTNT (NR vs 23 months; P = .02) and a 
      trend toward better OS. We conclude that achievement of MRD negativity predicts 
      for better response durability and trend toward improved OS and an increased 
      proportion of pPC predicts for better outcomes within those who have residual 
      tumor cells highlighting the importance of marrow normalization.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Tschautscher, Marcella A
AU  - Tschautscher MA
AUID- ORCID: 0000-0002-4529-7405
AD  - Division of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Jevremovic, Dragan
AU  - Jevremovic D
AD  - Division of Hematopathology, Mayo Clinic, Rochester, Minnesota.
FAU - Rajkumar, Vincent
AU  - Rajkumar V
AUID- ORCID: 0000-0002-5862-1833
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Dispenzieri, Angela
AU  - Dispenzieri A
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Lacy, Martha Q
AU  - Lacy MQ
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Gertz, Morie A
AU  - Gertz MA
AUID- ORCID: 0000-0002-3853-5196
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Buadi, Francis K
AU  - Buadi FK
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Dingli, David
AU  - Dingli D
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Hwa, Yi L
AU  - Hwa YL
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Fonder, Amie L
AU  - Fonder AL
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Hobbs, Miriam A
AU  - Hobbs MA
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Hayman, Suzanne R
AU  - Hayman SR
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Zeldenrust, Steven R
AU  - Zeldenrust SR
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Lust, John A
AU  - Lust JA
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Russell, Stephen J
AU  - Russell SJ
AD  - Division of Hematology and Molecular Medicine, Mayo Clinic, Rochester, Minnesota.
FAU - Leung, Nelson
AU  - Leung N
AUID- ORCID: 0000-0002-5651-1411
AD  - Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo 
      Clinic, Rochester, Minnesota.
FAU - Kapoor, Prashant
AU  - Kapoor P
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Go, Ronald S
AU  - Go RS
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Lin, Yi
AU  - Lin Y
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Gonsalves, Wilson I
AU  - Gonsalves WI
AUID- ORCID: 0000-0001-6890-969X
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Kourelis, Taxiarchis
AU  - Kourelis T
AUID- ORCID: 0000-0001-8573-9434
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Warsame, Rahma
AU  - Warsame R
AUID- ORCID: 0000-0003-0240-0326
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Kyle, Robert A
AU  - Kyle RA
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
FAU - Kumar, Shaji K
AU  - Kumar SK
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota.
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
DEP - 20190430
PL  - United States
TA  - Am J Hematol
JT  - American journal of hematology
JID - 7610369
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Bone Marrow/metabolism/pathology
MH  - Disease-Free Survival
MH  - Female
MH  - Flow Cytometry
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Multiple Myeloma/metabolism/mortality/pathology/therapy
MH  - Neoplasm, Residual/therapy
MH  - *Plasma Cells/metabolism/pathology
MH  - Retrospective Studies
MH  - Survival Rate
EDAT- 2019/04/05 06:00
MHDA- 2020/03/11 06:00
CRDT- 2019/04/05 06:00
PHST- 2019/02/12 00:00 [received]
PHST- 2019/03/31 00:00 [revised]
PHST- 2019/04/01 00:00 [accepted]
PHST- 2019/04/05 06:00 [pubmed]
PHST- 2020/03/11 06:00 [medline]
PHST- 2019/04/05 06:00 [entrez]
AID - 10.1002/ajh.25481 [doi]
PST - ppublish
SO  - Am J Hematol. 2019 Jul;94(7):751-756. doi: 10.1002/ajh.25481. Epub 2019 Apr 30.