Minimal residual disease in multiple myeloma: Benefits of flow cytometry

Abstract

Over the last 20 years, the approaches to the treatment of multiple myeloma (MM) have changed considerably, which led to an increase in remission rate. Using new diagnostic methods has made it possible to assess the response to treatment more reliably and forecast disease recurrence: allele-specific polymerase chain reaction, new-generation sequencing and multicolor flow cytometry enable minimal residual disease (MRD) detection of with sensitivity of 10 −5 to 10 −6. MRD assessment with flow cytometry using is a rapidly developing area of research. The goal of multicenter groups that use flow cytometry as a tool to detect MRD in patients with MM is achieving standardization and increasing sensitivity and specificity of this method. This article provides data about the methods used for MRD monitoring and describes the advances in the field of flow cytometry.

Malignant plasmacytes in bone marrow detected by flow cytometry as a predictor for the risk stratification system of multiple myeloma

“…However, it would be most valuable to PCs and CD27, CD19 and CD56 to distinguish between normal and abnormal PCs according to existing literature (Alaterre et al, 2018;Flores-Montero et al, 2016;Tarín et al, 2019). This abnormal phenotype of BM plasma cells has been used to study minimal residual disease in MM, and it has been shown that the persistence of abnormal immunophenotype PC in BM after treatment is associated with poor clinical outcomes (Davies et al, 2002;Galtseva et al, 2018). The results showed that the BMPCs detected by MFC was an attractive companion assessment to morphologic evaluation of a BM smear' furthermore it is a readily available and highly sensitive method to identify and quantify malignant PCs.…”

Limitations of VS38c labeling in the detection of plasma cell myeloma by flow cytometry

“…For proper response assessment, the detection of residual cancer cells in the BM (measurable residual disease [MRD]) is crucial [3, 4]. Upon diagnosis, myeloma cells can be identified by flow cytometry according to their high CD138 and CD38 expression, often increased CD56, CD20, or CD117 level compared to the normal plasma cells, and loss of CD45 or CD81 in most cases [5].…”

Validation of a modified pre‐lysis sample preparation technique for flow cytometric minimal residual disease assessment in multiple myeloma, chronic lymphocytic leukemia, and B‐non Hodgkin lymphoma

“…Minimal residual disease (MRD) assessment is a powerful prognostic tool and an essential part of patient management for a number of hematologic malignancies (Galtseva, Davydova, Kapranov, Julhakyan, & Mendeleeva, 2018;Paiva, Puig, Cedena, et al, 2020;Paiva, van Dongen, & Orfao, 2015;Paiva, Vidriales, Cervero, et al, 2008;Rawstron, Bottcher, Letestu, et al, 2013;Roshal, 2018;Schuurhuis, Heuser, Freeman, et al, 2018;Theunissen, Mejstrikova, Sedek, et al, 2017). With novel therapies resulting in more frequent deeper responses, the number of patients achieving longer remissions and improved overall survival continues to increase (Galtseva et al, 2018;Rawstron et al, 2013). The need for highly sensitive laboratory assays for assessment of MRD has evolved as a central component of patient monitoring, prognosis, and ongoing care.…”

“…Multi-parametric flow cytometry (MFC) is a timely, relatively cost effective, and sensitive method for assessment of MRD (Jelinek, Bezdekova, Zatopkova, et al, 2017;O'Donnell, Ernst, & Hingorani, 2013). With continued improvements in diagnostic performance, highly sensitive MFC (10 −5 to 10 −6 ) is rapidly transitioning from research to routine clinical care (Galtseva et al, 2018;Jelinek et al, 2017;Kumar et al, 2016;Paiva et al, 2008;Paiva et al, 2015;Paiva et al, 2020;Rawstron et al, 2013;Roshal, 2018;Schuurhuis et al, 2018;Theunissen et al, 2017). However, implementing recent advances in MFC MRD assessment presents economic and technical challenges for diagnostic laboratories.…”