High-risk cytogenetics and persistent minimal residual disease by multiparameter flow cytometry predict unsustained complete response after autologous stem cell transplantation in multiple myeloma.

Autores de IIS La Fe

• Lourdes Cordón Gallego

  Autor

• 

  Javier De La Rubia Comos

  Autor

Participantes ajenos a IIS La Fe

• Paiva B
• Gutiérrez NC
• Rosiñol L
• Vídriales MB
• Montalbán MÁ
• Martínez-López J
• Mateos MV
• Cibeira MT
• Oriol A
• Terol MJ
• Echeveste MA
• de Paz R
• de Arriba F
• Palomera L
• Díaz-Mediavilla J
• Sureda A
• Gorosquieta A
• Alegre A
• Martin A
• Hernández MT
• Lahuerta JJ
• Bladé J
• San Miguel JF
• PETHEMA/GEM (Programa para el Estudio de la Terapéutica en Hemopatías Malignas/G

Grupos

• Hematología y Hemoterapia

Abstract

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.