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Clinical applicability and prognostic significance of molecular response assessed by fluorescent‐ PCR of immunoglobulin genes in multiple myeloma. Results from a GEM / PETHEMA study
Author(s) -
MartinezLopez Joaquin,
FernándezRedondo Elena,
GarcíaSánz Ramón,
Montalbán María Angeles,
MartínezSánchez Pilar,
Pavia Bruno,
Mateos María Victoria,
Rosiñol Laura,
Martín Marisa,
Ayala Rosa,
Martínez Rafael,
Blanchard María Jesus,
Alegre Adrian,
Besalduch Joan,
Bargay Joan,
Hernandez Miguel T.,
Sarasquete María Eugenia,
SanchezGodoy Pedro,
Fernández Manuela,
Blade Joan,
San Miguel Jesús F.,
Lahuerta Juan Jose
Publication year - 2013
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.12576
Subject(s) - minimal residual disease , flow cytometry , multiple myeloma , real time polymerase chain reaction , microbiology and biotechnology , polymerase chain reaction , medicine , multiplex , immunology , biology , gastroenterology , gene , bone marrow , bioinformatics , genetics
Summary Minimal residual disease monitoring is becoming increasingly important in multiple myeloma ( MM ), but multiparameter flow cytometry ( MFC ) and allele‐specific oligonucleotide polymerase chain reaction ( ASO ‐ PCR ) techniques are not routinely available. This study investigated the prognostic influence of achieving molecular response assessed by fluorescent‐ PCR (F‐ PCR ) in 130 newly diagnosed MM patients from G rupo E spañol M ultidisciplinar de M elanoma ( GEM )2000/ GEM 05 trials ( NCT 00560053, NCT 00443235, NCT 00464217) who achieved almost very good partial response after induction therapy. As a reference, we used the results observed with simultaneous MFC . F‐ PCR at diagnosis was performed on DNA using three different multiplex PCR s: IGH D‐J, IGK V‐J and KDE rearrangements. The applicability of F‐ PCR was 91·5%. After induction therapy, 64 patients achieved molecular response and 66 non‐molecular response; median progression‐free survival ( PFS ) was 61 versus 36 months, respectively ( P = 0·001). Median overall survival ( OS ) was not reached ( NR ) in molecular response patients (5‐year survival: 75%) versus 66 months in the non‐molecular response group ( P = 0·03). The corresponding PFS and OS values for patients with immunophenotypic versus non‐immunophenotypic response were 67 versus 42 months ( P = 0·005) and NR (5‐year survival: 95%) versus 69 months ( P = 0·004), respectively. F‐ PCR analysis is a rapid, affordable, and easily performable technique that, in some circumstances, may be a valid approach for minimal residual disease investigations in MM .