Background and Objectives. Recent advances in the treatment of multiple myeloma (MM) include use of high-dose chemoradiotherapy followed by allografting. Although allografting with bone marrow (BM) or peripheral blood stem cells (PBSC) seems to imporve 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 allo-grafting with PBSC (6 patients) or BM (8 patients). Design and Methods. Among the 30 out of 72 MM patients in our institute who achieved CR after allo-grafting, 14 had a molecular marker suitable for allo-specific polymerase chain reaction (PCR) analysis. Stringent molecular monitoring was done using clonal markers based upon rearranged immunoglobulin heavy-chain genes. Molecular remission (MCR) was defined as two consecutive negative PCR results. Results. Seven 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 5 months (PBSC group), respectively. Of the seven patients (50%) who never achieved MCR, one relapsed. Interpretation and Conclusions. In conclusion, 50% of the MM patients in CR studied by us also achieved stringently-defined MCR. MCR was associated with a very low rate of clinical relapse. (C) 2000, Ferrata Storti Foundation.
|Number of pages||5|
|Publication status||Published - 2000|
- Allogeneic bone marrow transplantation
- Minimal residual disease
- Multiple myeloma
ASJC Scopus subject areas