Recent advances in the treatment of MM include use of high-dose chemoradiotherapy followed by allografting. Although allografting with bone marrow (BM) or peripheral blood stem cells (PBSC) seems to improve clinical outcome and lengthen survival, only about 50% of patients reach stringently defined complete remission (CR), and most subsequently relapse. We assessed the clinical relevance of minimal residual disease (MRD) in 14 MM patients in CR after allografting with PBSC (6 patients) or BM (8 patients). Among the 30 out of 72 MM patients in our Institute who achieved CR after allografting, 14 had a molecular marker suitable for allo-specific PCR. Stringent molecular monitoring was done using clonal markers based upon rearranged immunoglobulin heavychain genes. Molecular remission (MCR) was defined as two consecutive negative PCR results. 7 of 14 (50%) molecularly monitored patients, achieved MCR and did not relapse after a median molecular follow up of 60 months (range 36-120). Median time to obtain first PCR negativity was 12 (BM group) and 6 months (PBSC group), respectively. Of the seven patients (50%) who never achieved MCR, one relapsed. In conclusion, 50% of the MM patients in CR studied by us also achieved stringentlydefined MCR. MCR was associated with a very low rate of clinical relapse.
|Issue number||11 PART I|
|Publication status||Published - 2000|
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