Minimal Residual Disease Assessed by Multiparameter Flow Cytometry in Multiple Myeloma: Impact on Outcome in the Medical Research Council Myeloma IX Study

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Minimal Residual Disease Assessed by Multiparameter Flow Cytometry in Multiple Myeloma : Impact on Outcome in the Medical Research Council Myeloma IX Study. / Rawstron, Andy C; Child, J Anthony; de Tute, Ruth M; Davies, Faith E; Gregory, Walter M; Bell, Sue E; Szubert, Alexander J; Navarro-Coy, Nuria; Drayson, Mark T; Feyler, Sylvia; Ross, Fiona M; Cook, Gordon; Jackson, Graham H; Morgan, Gareth J; Owen, Roger G.

In: Journal of Clinical Oncology , Vol. 31, No. 20, 10.07.2013, p. 2540-7.

Research output: Contribution to journalArticlepeer-review

Harvard

Rawstron, AC, Child, JA, de Tute, RM, Davies, FE, Gregory, WM, Bell, SE, Szubert, AJ, Navarro-Coy, N, Drayson, MT, Feyler, S, Ross, FM, Cook, G, Jackson, GH, Morgan, GJ & Owen, RG 2013, 'Minimal Residual Disease Assessed by Multiparameter Flow Cytometry in Multiple Myeloma: Impact on Outcome in the Medical Research Council Myeloma IX Study', Journal of Clinical Oncology , vol. 31, no. 20, pp. 2540-7. https://doi.org/10.1200/JCO.2012.46.2119

APA

Rawstron, A. C., Child, J. A., de Tute, R. M., Davies, F. E., Gregory, W. M., Bell, S. E., Szubert, A. J., Navarro-Coy, N., Drayson, M. T., Feyler, S., Ross, F. M., Cook, G., Jackson, G. H., Morgan, G. J., & Owen, R. G. (2013). Minimal Residual Disease Assessed by Multiparameter Flow Cytometry in Multiple Myeloma: Impact on Outcome in the Medical Research Council Myeloma IX Study. Journal of Clinical Oncology , 31(20), 2540-7. https://doi.org/10.1200/JCO.2012.46.2119

Vancouver

Author

Rawstron, Andy C ; Child, J Anthony ; de Tute, Ruth M ; Davies, Faith E ; Gregory, Walter M ; Bell, Sue E ; Szubert, Alexander J ; Navarro-Coy, Nuria ; Drayson, Mark T ; Feyler, Sylvia ; Ross, Fiona M ; Cook, Gordon ; Jackson, Graham H ; Morgan, Gareth J ; Owen, Roger G. / Minimal Residual Disease Assessed by Multiparameter Flow Cytometry in Multiple Myeloma : Impact on Outcome in the Medical Research Council Myeloma IX Study. In: Journal of Clinical Oncology . 2013 ; Vol. 31, No. 20. pp. 2540-7.

Bibtex

@article{c7a6d865e52b4490b02b0315f0395e14,
title = "Minimal Residual Disease Assessed by Multiparameter Flow Cytometry in Multiple Myeloma: Impact on Outcome in the Medical Research Council Myeloma IX Study",
abstract = "PURPOSE To investigate the prognostic value of minimal residual disease (MRD) assessment in patients with multiple myeloma treated in the MRC (Medical Research Council) Myeloma IX trial. PATIENTS AND METHODS Multiparameter flow cytometry (MFC) was used to assess MRD after induction therapy (n = 378) and at day 100 after autologous stem-cell transplantation (ASCT; n = 397) in intensive-pathway patients and at the end of induction therapy in non-intensive-pathway patients (n = 245). Results In intensive-pathway patients, absence of MRD at day 100 after ASCT was highly predictive of a favorable outcome (PFS, P <.001; OS, P = .0183). This outcome advantage was demonstrable in patients with favorable and adverse cytogenetics (PFS, P = .014 and P <.001, respectively) and in patients achieving immunofixation-negative complete response (CR; PFS, P = .0068). The effect of maintenance thalidomide was assessed, with the shortest PFS demonstrable in those MRD-positive patients who did not receive maintenance and longest in those who were MRD negative and did receive thalidomide (P <.001). Further analysis demonstrated that 28% of MRD-positive patients who received maintenance thalidomide became MRD negative. MRD assessment after induction therapy in the non-intensive-pathway patients did not seem to be predictive of outcome (PFS, P = .1). CONCLUSION MRD assessment by MFC was predictive of overall outcome in patients with myeloma undergoing ASCT. This predictive value was seen in patients achieving conventional CR as well as patients with favorable and adverse cytogenetics. The effects of maintenance strategies can also be evaluated, and our data suggest that maintenance thalidomide can eradicate MRD in some patients.",
author = "Rawstron, {Andy C} and Child, {J Anthony} and {de Tute}, {Ruth M} and Davies, {Faith E} and Gregory, {Walter M} and Bell, {Sue E} and Szubert, {Alexander J} and Nuria Navarro-Coy and Drayson, {Mark T} and Sylvia Feyler and Ross, {Fiona M} and Gordon Cook and Jackson, {Graham H} and Morgan, {Gareth J} and Owen, {Roger G}",
year = "2013",
month = jul,
day = "10",
doi = "10.1200/JCO.2012.46.2119",
language = "English",
volume = "31",
pages = "2540--7",
journal = "Journal of Clinical Oncology ",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "20",

}

RIS

TY - JOUR

T1 - Minimal Residual Disease Assessed by Multiparameter Flow Cytometry in Multiple Myeloma

T2 - Impact on Outcome in the Medical Research Council Myeloma IX Study

AU - Rawstron, Andy C

AU - Child, J Anthony

AU - de Tute, Ruth M

AU - Davies, Faith E

AU - Gregory, Walter M

AU - Bell, Sue E

AU - Szubert, Alexander J

AU - Navarro-Coy, Nuria

AU - Drayson, Mark T

AU - Feyler, Sylvia

AU - Ross, Fiona M

AU - Cook, Gordon

AU - Jackson, Graham H

AU - Morgan, Gareth J

AU - Owen, Roger G

PY - 2013/7/10

Y1 - 2013/7/10

N2 - PURPOSE To investigate the prognostic value of minimal residual disease (MRD) assessment in patients with multiple myeloma treated in the MRC (Medical Research Council) Myeloma IX trial. PATIENTS AND METHODS Multiparameter flow cytometry (MFC) was used to assess MRD after induction therapy (n = 378) and at day 100 after autologous stem-cell transplantation (ASCT; n = 397) in intensive-pathway patients and at the end of induction therapy in non-intensive-pathway patients (n = 245). Results In intensive-pathway patients, absence of MRD at day 100 after ASCT was highly predictive of a favorable outcome (PFS, P <.001; OS, P = .0183). This outcome advantage was demonstrable in patients with favorable and adverse cytogenetics (PFS, P = .014 and P <.001, respectively) and in patients achieving immunofixation-negative complete response (CR; PFS, P = .0068). The effect of maintenance thalidomide was assessed, with the shortest PFS demonstrable in those MRD-positive patients who did not receive maintenance and longest in those who were MRD negative and did receive thalidomide (P <.001). Further analysis demonstrated that 28% of MRD-positive patients who received maintenance thalidomide became MRD negative. MRD assessment after induction therapy in the non-intensive-pathway patients did not seem to be predictive of outcome (PFS, P = .1). CONCLUSION MRD assessment by MFC was predictive of overall outcome in patients with myeloma undergoing ASCT. This predictive value was seen in patients achieving conventional CR as well as patients with favorable and adverse cytogenetics. The effects of maintenance strategies can also be evaluated, and our data suggest that maintenance thalidomide can eradicate MRD in some patients.

AB - PURPOSE To investigate the prognostic value of minimal residual disease (MRD) assessment in patients with multiple myeloma treated in the MRC (Medical Research Council) Myeloma IX trial. PATIENTS AND METHODS Multiparameter flow cytometry (MFC) was used to assess MRD after induction therapy (n = 378) and at day 100 after autologous stem-cell transplantation (ASCT; n = 397) in intensive-pathway patients and at the end of induction therapy in non-intensive-pathway patients (n = 245). Results In intensive-pathway patients, absence of MRD at day 100 after ASCT was highly predictive of a favorable outcome (PFS, P <.001; OS, P = .0183). This outcome advantage was demonstrable in patients with favorable and adverse cytogenetics (PFS, P = .014 and P <.001, respectively) and in patients achieving immunofixation-negative complete response (CR; PFS, P = .0068). The effect of maintenance thalidomide was assessed, with the shortest PFS demonstrable in those MRD-positive patients who did not receive maintenance and longest in those who were MRD negative and did receive thalidomide (P <.001). Further analysis demonstrated that 28% of MRD-positive patients who received maintenance thalidomide became MRD negative. MRD assessment after induction therapy in the non-intensive-pathway patients did not seem to be predictive of outcome (PFS, P = .1). CONCLUSION MRD assessment by MFC was predictive of overall outcome in patients with myeloma undergoing ASCT. This predictive value was seen in patients achieving conventional CR as well as patients with favorable and adverse cytogenetics. The effects of maintenance strategies can also be evaluated, and our data suggest that maintenance thalidomide can eradicate MRD in some patients.

U2 - 10.1200/JCO.2012.46.2119

DO - 10.1200/JCO.2012.46.2119

M3 - Article

C2 - 23733781

VL - 31

SP - 2540

EP - 2547

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 20

ER -