Prognostic value of minimal residual disease detected by EuroFlow next-generation flow cytometry and next-generation sequencing in patients with multiple myeloma achieving complete response and receiving lenalidomide maintenance after autotransplant: a prospective comparison study
Takeshi Yoroidaka,
Hiroyuki Takamatsu,
Ryota Urushihara,
Mitsuhiro Itagaki,
Satoshi Yoshihara,
Kota Sato,
Naoki Takezako,
Shuji Ozaki,
Kazuhito Suzuki,
Kentaro Kohno,
Tsuyoshi Muta,
Morio Matsumoto,
Yasushi Terasaki,
Takeshi Yamashita,
Shin-ichi Fuchida,
Jun Sakamoto,
Tadao Ishida,
Kenshi Suzuki,
Hirokazu Murakami,
Brian G.M. Durie,
Kazuyuki Shimizu
Affiliations
Takeshi Yoroidaka
Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa
Hiroyuki Takamatsu
Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa
Ryota Urushihara
Department of Hematology, Toyama Prefectural Central Hospital, Toyama
Mitsuhiro Itagaki
Department of Hematology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima
Satoshi Yoshihara
Department of Respiratory Medicine and Hematology, Hyogo College of Medicine, Nishinomiya
Kota Sato
Department of Hematology, Japanese Red Cross Medical Center, Tokyo
Naoki Takezako
Department of Hematology, Nerima Hikarigaoka Hospital, Tokyo
Shuji Ozaki
Department of Hematology, Tokushima Prefectural Central Hospital, Tokushima
Kazuhito Suzuki
Division of Clinical Oncology and Hematology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo
Kentaro Kohno
Department of Hematology, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyushu
Tsuyoshi Muta
Department of Hematology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima
Morio Matsumoto
Department of Hematology, NHO Shibukawa Medical Center, Shibukawa
Yasushi Terasaki
Division of Hematology, Toyama City Hospital, Toyama
Takeshi Yamashita
Department of Hematology, Ishikawa Prefectural Central Hospital, Kanazawa
Shin-ichi Fuchida
Department of Hematology, Japan Community Health care Organization Kyoto Kuramaguchi Medical Center, Kyoto
Jun Sakamoto
Bio Medical Laboratories (BML), INC., Kawagoe
Tadao Ishida
Department of Hematology, Japanese Red Cross Medical Center, Tokyo
Kenshi Suzuki
Department of Hematology, Japanese Red Cross Medical Center, Tokyo
Hirokazu Murakami
Faculty of Medical Technology and Clinical Engineering, Gunma University of Health and Welfare, Maebashi
Brian G.M. Durie
Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Outpatient Cancer Center, Los Angeles, CA
Kazuyuki Shimizu
Department of Hematology, Higashi Nagoya National Hospital, Nagoya
Novel agents inducing deeper responses have improved the prognosis of patients with multiple myeloma (MM). To assess minimal residual disease (MRD) and stratify patients achieving complete response (CR), advanced technologies such as EuroFlow next-generation flow cytometry (NGF) and next-generation sequencing (NGS) are increasingly utilized. This prospective study evaluated responses in newly diagnosed MM patients undergoing autologous stem cell transplantation (ASCT) followed by lenalidomide maintenance therapy across multiple Japanese medical centers. Patients achieving CR or stringent CR within 100-365 days post-ASCT were included. MRD levels in the bone marrow were assessed using both NGF and NGS (cutoff: 1×10-5) at three time points: 100–365 days, 1 year, and 2 years post-ASCT. A total of 52 patients were analyzed. MRD levels determined by NGF and NGS showed a strong correlation (r = 0.9722, P 6 months demonstrated superior three-year PFS compared to those without sustained MRD negativity, as measured by both NGF (100% vs. 67.6%; hazard ratio [HR] 0.06; 95% CI, 0.0005–0.50; P < 0.007) and NGS (90.5% vs. 72.2%; HR 0.23; 95% CI, 0.06–0.94; P = 0.048). These findings highlighted a strong correlation in the MRD levels assessed by NGF and NGS and validated that sustained MRD negativity was significantly associated with prolonged PFS. (Trial registered at UMIN 000022238).
