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Blood, 15 November 2008, Vol. 112, No. 10, pp. 4017-4023. Prepublished online as a Blood First Edition Paper on July 31, 2008; DOI 10.1182/blood-2008-05-159624. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2008-05-159624v1 112/10/4017    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Paiva, B. Articles by San Miguel, J. F. Search for Related Content PubMed PubMed Citation Articles by Paiva, B. Articles by San Miguel, J. F. Related Collections Neoplasia Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Multiparameter flow cytometric remission is the most relevant prognostic factor for multiple myeloma patients who undergo autologous stem cell transplantation Bruno Paiva1,*, Maria-Belén Vidriales1,2,*, Jorge Cerveró1, Gema Mateo1,2, Jose J. Pérez1, Maria A. Montalbán3, Anna Sureda4, Laura Montejano3, Norma C. Gutiérrez1,2, Alfonso García de Coca5, Natalia de las Heras6, Maria V. Mateos1,2, Maria C. López-Berges1, Raimundo García-Boyero7, Josefina Galende8, Jose Hernández9, Luis Palomera10, Dolores Carrera11, Rafael Martínez12, Javier de la Rubia13, Alejandro Martín14, Joan Bladé15, Juan J. Lahuerta3, Alberto Orfao2,16, Jesús F. San Miguel1,2, on behalf of the GEM (Grupo Español de MM)/PETHEMA (Programa para el Estudio de la Terapéutica en Hemopatías Malignas) cooperative study groups 1 Hospital Universitario de Salamanca, Salamanca; 2 Centro de Investigación del Cáncer (CIC, IBMCC USAL-CSIC), Salamanca; 3 Hospital 12 de Octubre, Madrid; 4 Hospital Santa Creu I Sant Pau, Barcelona; 5 Hospital Clínico Universitario de Valladolid, Valladolid; 6 Complejo Hospitalario de León, León; 7 Hospital General de Castellón, Castellón; 8 Hospital del Bierzo, Ponferrada; 9 Hospital General de Segovia, Segovia; 10 Hospital Lozano Blesa, Zaragoza; 11 Hospital Central de Asturias, Oviedo; 12 Clínico San Carlos, Madrid; 13 Hospital La Fe, Valencia; 14 Hospital Virgen de la Concha, Zamora; 15 Hospital Clínic, Institut d'Investigaciones Biomediques August Pi i Sunyer, Barcelona; and 16 Servicio General de Citometría, Universidad de Salamanca, Salamanca, Spain Minimal residual disease (MRD) assessment is standard in many hematologic malignancies but is considered investigational in multiple myeloma (MM). We report a prospective analysis of the prognostic importance of MRD detection by multiparameter flow cytometry (MFC) in 295 newly diagnosed MM patients uniformly treated in the GEM2000 protocol VBMCP/VBAD induction plus autologous stem cell transplantation [ASCT]). MRD status by MFC was determined at day 100 after ASCT. Progression-free survival (PFS; median 71 vs 37 months, P < .001) and overall survival (OS; median not reached vs 89 months, P = .002) were longer in patients who were MRD negative versus MRD positive at day 100 after ASCT. Similar prognostic differentiation was seen in 147 patients who achieved immunofixation-negative complete response after ASCT. Moreover, MRD– immunofixation-negative (IFx–) patients and MRD– IFx+ patients had significantly longer PFS than MRD+ IFx– patients. Multivariate analysis identified MRD status by MFC at day 100 after ASCT as the most important independent prognostic factor for PFS (HR = 3.64, P = .002) and OS (HR = 2.02, P = .02). Our findings demonstrate the clinical importance of MRD evaluation by MFC, and illustrate the need for further refinement of MM re-sponse criteria. This trial is registered at http://clinicaltrials.gov under identifier NCT00560053 [ClinicalTrials.gov] . CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Going with the flow, and beyond, in myeloma Bart Barlogie, Joshua Epstein, and John D. Shaughnessy, Jr Blood 2008 112: 3917-3918. [Full Text] [PDF] This article has been cited by other articles: B. Paiva, M.-B. Vidriales, G. Mateo, J. J. Perez, M. A. Montalban, A. Sureda, L. Montejano, N. C. Gutierrez, A. Garcia de Coca, N. de las Heras, et al. The persistence of immunophenotypically normal residual bone marrow plasma cells at diagnosis identifies a good prognostic subgroup of symptomatic multiple myeloma patients Blood, November 12, 2009; 114(20): 4369 - 4372. [Abstract] [Full Text] [PDF] B. Paiva, M.-B. Vidriales, J. J. Perez, G. Mateo, M. A. Montalban, M. V. Mateos, J. Blade, J. J. Lahuerta, A. Orfao, and J. F. San Miguel Multiparameter flow cytometry quantification of bone marrow plasma cells at diagnosis provides more prognostic information than morphological assessment in myeloma patients Haematologica, November 1, 2009; 94(11): 1599 - 1602. [Abstract] [Full Text] [PDF] J.-L. Harousseau, M. Attal, and H. Avet-Loiseau The role of complete response in multiple myeloma Blood, October 8, 2009; 114(15): 3139 - 3146. [Abstract] [Full Text] [PDF]

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