Praktyka kliniczna oceny minimalnej choroby resztkowej u chorych na szpiczaka plazmocytowego w Polsce: badanie ankietowe Polskiego Konsorcjum Szpiczakowego

Abstract

Studies exploring the significance of minimal residual disease (MRD) in plasma cell myeloma (PCM) have proven its prognostic value, regardless of the type of administered treatment. In order to assess the current practice for evaluating MRD in Poland, we conducted a survey on the methods for assessing MRD and on the MRD testing time points at Polish hematological centres. Seven out of 15 institutions surveyed use of the flow cytometry (FC) method for MRD assessment. The FC-MRD assessment is performed uniformly only in those patients achieving complete remission (CR). However, the specific indications and assessment time points differed at the tested centres including: testing MRD only after autologous hematopoietic stem cell transplantation (auto-HSCT), after auto-HSCT and consolidation, after completion of first line chemotherapy or after obtaining CR in any line of treatment. The study also showed considerable heterogeneity in the FC-MRD methodology, which affects test sensitivity (from 10-3 to 10-5). None of the surveyed centres uses molecular techniques for MRD assessment. In 8 of the 15 institutions, patients are monitored by imaging techniques. Our survey may thus be useful for developing guidelines and standardization of MRD assessment in PCM in Poland.

Harmonization of Flow Cytometric Minimal Residual Disease Assessment in Multiple Myeloma in Centers of Polish Myeloma Consortium

“…The advantages of utilizing MFC for MRD assessment include broa availability, cost-effectiveness and fast turnaround time. However, as was also seen in ou previous study, MFC MRD tests may suffer from interlaboratory variations caused b differences in antibody panel, staining protocols, methods of analysis and interpretation and result in different sensitivity achieved [23,28,29]. Due to the relevance and usefulnes of the MRD tests in MM, a series of efforts to standardize the technique have bee undertaken.…”

“…However, at least in Poland, a significant inter-center heterogeneity concerning MRD assessment in MM could be noted. In 2017, a survey study was conducted by the Polish Myeloma Consortium, with the aim to assess the technical capabilities and routine approach to MRD determination in patients with MM [23]. Although at that time, flow cytometry MM MRD assays were performed in only 46% out of the 15 surveyed clinical centers, all survey participants saw a need for establishing a routine MRD determination method in MM.…”

Role of flow cytometric measurable residual disease assessment in multiple myeloma

“…The diversity of the procedures regarding the number of cells analyzed, the antibody combinations, the analytical strategies, and reporting has significantly impacted the test sensitivity obtained in different centers [51]. The results of a survey analyzing the method of MRD assessment in MM in Poland showed a high variability of procedures and as much as a 100-fold difference in the sensitivity achieved between different laboratories [52]. Subsequently, harmonizing cytometer parameters and assay protocols in four cytometric laboratories allowed a high, 95%, concordance of results obtained in laboratories, even in samples with very few pathological PCs [53].…”

Znaczenie minimalnej choroby resztkowej w szpiczaku plazmocytowym — Stanowisko Polskiego Konsorcjum Szpiczakowego

“…W celu analizy aktualnie stosowanej praktyki oceny MRD u chorych na PCM, dostępności niezbędnej aparatury i wykwalifikowanego personelu oraz planów dotyczących tego zagadnienia przeprowadzono badanie ankietowe obejmujące 15 polskich ośrodków hematologicznych. Wyniki tego badania podsumowano w artykule zawartym w niniejszym numerze "Hematologii" [42]. Ponadto 20 kwietnia 2017 roku we Wrocławiu, pod patronatem naukowym PMC, odbyły się warsztaty szkoleniowe pt.…”