Journal Article Ahead of print
PubMed: 42312383 DOI: 10.1111/bjh.70606
Measurable residual disease assessment in apheresis product from multiple myeloma patients: Correlation with biology, depth of response and survival.
Br J Haematol
Authors: Borja Puertas, Irene Padilla, Elena Alejo, Fe Serra-Toral, Aránzazu García-Mateo, Rosa López-López, Abelardo Bárez, José María Alonso-Alonso, Carlos Aguilar-Franco, Erik de Cabo, Alberto Cantalapiedra-Diez, Alfonso García-Coca, Roberto Hernández, Beatriz Rey-Búa, Marta Fonseca-Santos, Miriam López-Parra, Lucía López-Corral, Norma C Gutiérrez, María Belén Vidriales-Vicente, José J Pérez, Verónica González-Calle, María-Victoria Mateos, Fernando Escalante, Juan Flores-Montero, Noemi Puig
Affiliations
- Hematology Department, University Hospital of Salamanca/Instituto de Investigación Biomédica de Salamanca/Cancer Research Center IBMCC, Centro de Investigación Biomédica en Red del Cáncer, Salamanca, Spain.
- Hematology Department, University Hospital of León, IBILEON, León, Spain.
- Hematology Department, University Hospital of Burgos, Burgos, Spain.
- Hematology Department, University Hospital of Segovia, Segovia, Spain.
- Hematology Department, University Hospital of Virgen del Puerto, Plasencia, Spain.
- Hematology Department, University Hospital Nuestra Señora de Sonsoles, Ávila, Spain.
- Hematology Department, Hospital Río Carrión, Palencia, Spain.
- Hematology Department, University Hospital Santa Bárbara, Soria, Spain.
- Hematology Department, University Hospital El Bierzo, León, Spain.
- Hematology Department, University Hospital Rio Hortega, Valladolid, Spain.
- Hematology Department, University Clinical Hospital of Valladolid, Valladolid, Spain.
- Hematology Department, University Hospital Virgen de la Concha, Zamora, Spain.
Abstract
While measurable residual disease (MRD) in bone marrow (bmMRD) is a validated surrogate biomarker in multiple myeloma (MM), the clinical relevance of MRD in the apheresis product (aMRD) remains unclear. We retrospectively analysed 422 MM patients who underwent autologous stem cell transplantation (ASCT) between 2005 and 2023 at the University Hospital of Salamanca, all evaluated for aMRD by 8-colour flow cytometry. Overall, 45 patients (10%) were aMRD+ve and 377 (90%) were aMRD-ve, with similar baseline characteristics except for a higher frequency of t(11;14) in aMRD+ve cases. Patients with responses worse than a very good partial response before apheresis were six times more likely to be aMRD+ve (odds ratio [OR] 6.6, p = 0.006), and notably, no patients with bmMRD-ve status prior to apheresis were aMRD+ve. After ASCT, patients with aMRD+ve exhibited lower rates of complete response and bmMRD-ve than patients with aMRD-ve, leading to a shorter progression-free survival (hazard ratio 1.7, p = 0.006), and aMRD+ve status was identified as an independent predictor of early relapse (OR 9.75, p = 0.007). These findings may suggest that aMRD+ve serves as a critical early biomarker to identify suboptimal treatment responses, reflecting bmMRD persistence and predicting inferior clinical outcomes.
MeSH
Hematology, Blood Component Removal, Biomarkers, Multiple Myeloma