Multiple myeloma: PET-CT helps overcome limitations of MRD assessment

  • Alonso R & al.
  • Am J Hematol
  • 9 May 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • In patients with newly diagnosed multiple myeloma (NDMM), the combined use of positron emission tomography-computed tomography (PET-CT) and minimal residual disease (MRD) assessment by multiparameter flow cytometry (MFC) enabled improved predictive power in identifying patient subgroups with different prognoses.  

Why this matters

  • MM is characterized by relatively homogenous bone marrow infiltration; however, MRD assessment based on bone marrow samples is of limited utility in assessing patients with extramedullary disease or heterogeneous bone marrow involvement.

Study design

  • Study to investigate the prognostic value of combining PET-CT with MRD assessment by MFC in 103 patients with NDMM.
  • PET-CT and MFC assessments were performed before and at successive points during first-line therapy.
  • Median patient age: 62 (range, 38-82) years.
  • Funding: Instituto de Salud Carlos III.  

Key results

  • Significant differences in median PFS in 87 patients in complete remission (CR) per complementary assessment results (P<.001 style="list-style-type:circle;">
  • 92 months in patients who were MRD-negative and PET-negative.
  • 57 months in patients who were MRD-positive and PET-negative.
  • 31 months in patients who were PET-positive.

Limitations

  • Retrospective data.