Imaging and bone marrow assessments improve minimal residual disease prediction in multiple myeloma
The value of minimal residual disease (MRD) status by bone marrow and imaging analysis as independent prognostic factors has been well established in multiple myeloma (MM). Nevertheless data about their potential complementarity for a more accurate assessment are limited. With this aim, we retrospec...
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| Veröffentlicht in: | American journal of hematology 2019-08, Vol.94 (8), p.853-861 |
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| creator | Alonso, Rafael Cedena, María Teresa Gómez‐Grande, Adolfo Ríos, Rafael Moraleda, José María Cabañas, Valentín Moreno, María José López‐Jiménez, Javier Martín, Fernando Sanz, Alejandro Valeri, Antonio Jiménez, Ana Sánchez, Ricardo Lahuerta, Juan José Martínez‐López, Joaquín |
| description | The value of minimal residual disease (MRD) status by bone marrow and imaging analysis as independent prognostic factors has been well established in multiple myeloma (MM). Nevertheless data about their potential complementarity for a more accurate assessment are limited. With this aim, we retrospectively analyzed the prediction of outcome with the combination of PET‐CT and MRD, assessed by multiparameter flow cytometry (MFC) in 103 patients with newly diagnosed MM. We confirmed the benefit in terms of progression‐free survival (PFS), linked to the achievement of negativity by MFC (hazard ratio [HR] 0.53; 95% confidence interval [CI]: 0.28‐0.98), and PET‐CT (HR 0.18; 95% CI: 0.09‐0.36) individually. By combining both techniques, patients who became MRD‐/PET‐, with a median of PFS 92 months, had significant prolonged median PFS (P |
| doi_str_mv | 10.1002/ajh.25507 |
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Nevertheless data about their potential complementarity for a more accurate assessment are limited. With this aim, we retrospectively analyzed the prediction of outcome with the combination of PET‐CT and MRD, assessed by multiparameter flow cytometry (MFC) in 103 patients with newly diagnosed MM. We confirmed the benefit in terms of progression‐free survival (PFS), linked to the achievement of negativity by MFC (hazard ratio [HR] 0.53; 95% confidence interval [CI]: 0.28‐0.98), and PET‐CT (HR 0.18; 95% CI: 0.09‐0.36) individually. By combining both techniques, patients who became MRD‐/PET‐, with a median of PFS 92 months, had significant prolonged median PFS (P < .001). This is compared with MRD+/PET‐ and PET+ patients (median PFS of 45 and 28 months, respectively). We observed a significant difference (P = .003) in overall survival (OS) outcomes between MRD‐/PET‐ and MRD+/PET‐ patients (4‐year OS 94.2% and 100%, respectively), vs PET+ patients (4‐year OS 73.8%). All survival results were confirmed in a conditional landmark analysis. These findings support the potential complementarity between PET‐CT and MFC, and highlight their better predictive capability when improving sensitivity.</description><identifier>ISSN: 0361-8609</identifier><identifier>EISSN: 1096-8652</identifier><identifier>DOI: 10.1002/ajh.25507</identifier><identifier>PMID: 31074033</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Bone imaging ; Bone marrow ; Bone Marrow - diagnostic imaging ; Bone Marrow - pathology ; Complementarity ; Computed tomography ; Flow Cytometry ; Hematology ; Humans ; Kaplan-Meier Estimate ; Medical prognosis ; Minimal residual disease ; Multiple myeloma ; Multiple Myeloma - diagnostic imaging ; Multiple Myeloma - mortality ; Multiple Myeloma - pathology ; Multiple Myeloma - therapy ; Neoplasm, Residual - diagnostic imaging ; Neoplasm, Residual - mortality ; Neoplasm, Residual - pathology ; Neoplasm, Residual - therapy ; Positron Emission Tomography Computed Tomography ; Progression-Free Survival ; Proportional Hazards Models ; Retrospective Studies ; Survival ; Whole Body Imaging</subject><ispartof>American journal of hematology, 2019-08, Vol.94 (8), p.853-861</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3887-12859e4c9d178ac471dc8b20c5eb37d957b81d3fcf41f25d4002b931f1d8d3f43</citedby><cites>FETCH-LOGICAL-c3887-12859e4c9d178ac471dc8b20c5eb37d957b81d3fcf41f25d4002b931f1d8d3f43</cites><orcidid>0000-0001-5904-0902 ; 0000-0002-6248-2549 ; 0000-0002-6383-0381 ; 0000-0001-5851-3720 ; 0000-0003-3774-118X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fajh.25507$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fajh.25507$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31074033$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alonso, Rafael</creatorcontrib><creatorcontrib>Cedena, María Teresa</creatorcontrib><creatorcontrib>Gómez‐Grande, Adolfo</creatorcontrib><creatorcontrib>Ríos, Rafael</creatorcontrib><creatorcontrib>Moraleda, José María</creatorcontrib><creatorcontrib>Cabañas, Valentín</creatorcontrib><creatorcontrib>Moreno, María José</creatorcontrib><creatorcontrib>López‐Jiménez, Javier</creatorcontrib><creatorcontrib>Martín, Fernando</creatorcontrib><creatorcontrib>Sanz, Alejandro</creatorcontrib><creatorcontrib>Valeri, Antonio</creatorcontrib><creatorcontrib>Jiménez, Ana</creatorcontrib><creatorcontrib>Sánchez, Ricardo</creatorcontrib><creatorcontrib>Lahuerta, Juan José</creatorcontrib><creatorcontrib>Martínez‐López, Joaquín</creatorcontrib><title>Imaging and bone marrow assessments improve minimal residual disease prediction in multiple myeloma</title><title>American journal of hematology</title><addtitle>Am J Hematol</addtitle><description>The value of minimal residual disease (MRD) status by bone marrow and imaging analysis as independent prognostic factors has been well established in multiple myeloma (MM). Nevertheless data about their potential complementarity for a more accurate assessment are limited. With this aim, we retrospectively analyzed the prediction of outcome with the combination of PET‐CT and MRD, assessed by multiparameter flow cytometry (MFC) in 103 patients with newly diagnosed MM. We confirmed the benefit in terms of progression‐free survival (PFS), linked to the achievement of negativity by MFC (hazard ratio [HR] 0.53; 95% confidence interval [CI]: 0.28‐0.98), and PET‐CT (HR 0.18; 95% CI: 0.09‐0.36) individually. By combining both techniques, patients who became MRD‐/PET‐, with a median of PFS 92 months, had significant prolonged median PFS (P < .001). This is compared with MRD+/PET‐ and PET+ patients (median PFS of 45 and 28 months, respectively). We observed a significant difference (P = .003) in overall survival (OS) outcomes between MRD‐/PET‐ and MRD+/PET‐ patients (4‐year OS 94.2% and 100%, respectively), vs PET+ patients (4‐year OS 73.8%). All survival results were confirmed in a conditional landmark analysis. These findings support the potential complementarity between PET‐CT and MFC, and highlight their better predictive capability when improving sensitivity.</description><subject>Bone imaging</subject><subject>Bone marrow</subject><subject>Bone Marrow - diagnostic imaging</subject><subject>Bone Marrow - pathology</subject><subject>Complementarity</subject><subject>Computed tomography</subject><subject>Flow Cytometry</subject><subject>Hematology</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Medical prognosis</subject><subject>Minimal residual disease</subject><subject>Multiple myeloma</subject><subject>Multiple Myeloma - diagnostic imaging</subject><subject>Multiple Myeloma - mortality</subject><subject>Multiple Myeloma - pathology</subject><subject>Multiple Myeloma - therapy</subject><subject>Neoplasm, Residual - diagnostic imaging</subject><subject>Neoplasm, Residual - mortality</subject><subject>Neoplasm, Residual - pathology</subject><subject>Neoplasm, Residual - therapy</subject><subject>Positron Emission Tomography Computed Tomography</subject><subject>Progression-Free Survival</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Survival</subject><subject>Whole Body Imaging</subject><issn>0361-8609</issn><issn>1096-8652</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1LxDAQhoMo7vpx8A9IwIse1s1Hs02PIn6sCF70XNJkqlmatCatsv_erF09CEIgw8zDy8yD0Akll5QQNlert0smBMl30JSSYjGTC8F20ZTwBU01KSboIMYVIZRmkuyjCackzwjnU6SXTr1a_4qVN7hqPWCnQmg_sYoRYnTg-4it60L7kUbWW6caHCBaM6TC2AgqAu4CGKt723psPXZD09uuSfwamtapI7RXqybC8fY_RC-3N8_X97PHp7vl9dXjTHMp8xllUhSQ6cLQXCqd5dRoWTGiBVQ8N4XIK0kNr3Wd0ZoJk6XTq4LTmhqZ2hk_ROdjbtr2fYDYl85GDU2jPLRDLBnjtBAiYxv07A-6aofg03aJEukJmW-oi5HSoY0xQF12IQkI65KScmO-TObLb_OJPd0mDpUD80v-qE7AfAQ-bQPr_5PKq4f7MfILpjCNUA</recordid><startdate>201908</startdate><enddate>201908</enddate><creator>Alonso, Rafael</creator><creator>Cedena, María Teresa</creator><creator>Gómez‐Grande, Adolfo</creator><creator>Ríos, Rafael</creator><creator>Moraleda, José María</creator><creator>Cabañas, Valentín</creator><creator>Moreno, María José</creator><creator>López‐Jiménez, Javier</creator><creator>Martín, Fernando</creator><creator>Sanz, Alejandro</creator><creator>Valeri, Antonio</creator><creator>Jiménez, Ana</creator><creator>Sánchez, Ricardo</creator><creator>Lahuerta, Juan José</creator><creator>Martínez‐López, Joaquín</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5904-0902</orcidid><orcidid>https://orcid.org/0000-0002-6248-2549</orcidid><orcidid>https://orcid.org/0000-0002-6383-0381</orcidid><orcidid>https://orcid.org/0000-0001-5851-3720</orcidid><orcidid>https://orcid.org/0000-0003-3774-118X</orcidid></search><sort><creationdate>201908</creationdate><title>Imaging and bone marrow assessments improve minimal residual disease prediction in multiple myeloma</title><author>Alonso, Rafael ; 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Nevertheless data about their potential complementarity for a more accurate assessment are limited. With this aim, we retrospectively analyzed the prediction of outcome with the combination of PET‐CT and MRD, assessed by multiparameter flow cytometry (MFC) in 103 patients with newly diagnosed MM. We confirmed the benefit in terms of progression‐free survival (PFS), linked to the achievement of negativity by MFC (hazard ratio [HR] 0.53; 95% confidence interval [CI]: 0.28‐0.98), and PET‐CT (HR 0.18; 95% CI: 0.09‐0.36) individually. By combining both techniques, patients who became MRD‐/PET‐, with a median of PFS 92 months, had significant prolonged median PFS (P < .001). This is compared with MRD+/PET‐ and PET+ patients (median PFS of 45 and 28 months, respectively). We observed a significant difference (P = .003) in overall survival (OS) outcomes between MRD‐/PET‐ and MRD+/PET‐ patients (4‐year OS 94.2% and 100%, respectively), vs PET+ patients (4‐year OS 73.8%). All survival results were confirmed in a conditional landmark analysis. These findings support the potential complementarity between PET‐CT and MFC, and highlight their better predictive capability when improving sensitivity.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>31074033</pmid><doi>10.1002/ajh.25507</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5904-0902</orcidid><orcidid>https://orcid.org/0000-0002-6248-2549</orcidid><orcidid>https://orcid.org/0000-0002-6383-0381</orcidid><orcidid>https://orcid.org/0000-0001-5851-3720</orcidid><orcidid>https://orcid.org/0000-0003-3774-118X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Bone imaging Bone marrow Bone Marrow - diagnostic imaging Bone Marrow - pathology Complementarity Computed tomography Flow Cytometry Hematology Humans Kaplan-Meier Estimate Medical prognosis Minimal residual disease Multiple myeloma Multiple Myeloma - diagnostic imaging Multiple Myeloma - mortality Multiple Myeloma - pathology Multiple Myeloma - therapy Neoplasm, Residual - diagnostic imaging Neoplasm, Residual - mortality Neoplasm, Residual - pathology Neoplasm, Residual - therapy Positron Emission Tomography Computed Tomography Progression-Free Survival Proportional Hazards Models Retrospective Studies Survival Whole Body Imaging |
| title | Imaging and bone marrow assessments improve minimal residual disease prediction in multiple myeloma |
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