High-risk cytogenetics and persistent minimal residual disease by multiparameter flow cytometry predict unsustained complete response after autologous stem cell transplantation in multiple myeloma
| Autor: | Luis Palomera, Joan Bladé, María-Belén Vidriales, Bruno Paiva, Alejandro Martín, María-Angeles Montalbán, Albert Oriol, Adrian Alegre, Lourdes Cordón, Maria-Victoria Mateos, Felipe de Arriba, MT Cibeira, María-Asunción Echeveste, Anna Sureda, Raquel de Paz, Juan José Lahuerta, Ana Gorosquieta, Jesús F. San Miguel, Laura Rosiñol, Miguel T. Hernandez, Norma C. Gutiérrez, Joaquín Díaz-Mediavilla, Javier de la Rubia, María-José Terol, Joaquin Martinez-Lopez |
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| Přispěvatelé: | Instituto de Salud Carlos III, Red Temática de Investigación Cooperativa en Cáncer (España), Junta de Castilla y León |
| Rok vydání: | 2012 |
| Předmět: |
Male
Oncology medicine.medical_specialty Neoplasm Residual Immunology Transplantation Autologous Biochemistry Autologous stem-cell transplantation Risk Factors Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Combined Modality Therapy Survival rate Dexamethasone Multiple myeloma Aged business.industry Remission Induction Hazard ratio Cell Biology Hematology Middle Aged Flow Cytometry medicine.disease Minimal residual disease Surgery Survival Rate Transplantation Treatment Outcome Cytogenetic Analysis Female Multiple Myeloma business Stem Cell Transplantation medicine.drug |
| Zdroj: | Digital.CSIC. Repositorio Institucional del CSIC instname |
| Popis: | et al. PETHEMA/GEM (Programa para el Estudio de la Terapéutica en Hemopatías Malignas/Grupo Español de Mieloma) Cooperative Study Groups. The achievement of complete response (CR) after high-dose therapy/autologous stem cell transplantation (HDT/ASCT) is a surrogate for prolonged survival in multiple myeloma; however, patients who lose their CR status within 1 year of HDT/ASCT (unsustained CR) have poor prognosis. Thus, the identification of these patients is highly relevant. Here, we investigate which prognostic markers can predict unsustained CR in a series of 241 patients in CR at day +100 after HDT/ASCT who were enrolled in the Spanish GEM2000 (n = 140) and GEM2005 < 65y (n = 101) trials. Twenty-nine (12%) of the 241 patients showed unsustained CR and a dismal outcome (median overall survival 39 months). The presence of baseline high-risk cytogenetics by FISH (hazard ratio 17.3; P = .002) and persistent minimal residual disease by multiparameter flow cytometry at day +100 after HDT/ASCT (hazard ratio 8.0; P = .005) were the only independent factors that predicted unsustained CR. Thus, these 2 parameters may help to identify patients in CR at risk of early progression after HDT/ASCT in whom novel treatments should be investigated. This work was supported by the Cooperative Research Thematic Network (RTICs; RD06/0020/0006, RD06/0020/0005, RD06/0020/0031, RD06/0020/0101, RD06/0020/1056, and G03/136), MM Jevitt, SL Firm, Instituto de Salud Carlos III/Subdirección General de Investigación Sanitaria (FIS: PI060339; 06/1354; 02/0905; 01/0089/01-02; PS09/01 897), and Consejería de Sanidad, Junta de Castilla y León, Valladolid, Spain (557/A/10). |
| Databáze: | OpenAIRE |
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