Prognostic role of minimal residual disease in multiple myeloma patients after non-myeloablative allogeneic transplantation

Galimberti, Sara; Benedetti, Enrico; Morabito, Fortunato; Papineschi, Federico; Callea, Vincenzo; Fazzi, Rita; Stelitano, Caterina; Andreazzoli, Francesca; Guerrini, Francesca; Ciabatti, Elena; Martino, Massimo; Nobile, Francesco; Iacopino, Pasquale; Petrini, Mario

doi:10.1016/j.leukres.2005.01.017

Cited by 56 publications

(34 citation statements)

References 23 publications

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“…Preliminary results from our study group and other investigators showed that by using nested PCR or real-time PCR, molecular remission can be achieved after dose-reduced allograft, and quantitative measurement of residual myeloma cells can be used for further post-transplant strategies in order to achieve molecular remission 51 Targeting molecular remission also implies the recently discovered myeloma stem cells, a rare population of cells that maintain the ability to self-renew and sustain tumor. 52 Antimyeloma agents such as bortezomib or lenalidomide have little activity against myeloma stem cells in vitro, whereas rituximab kills myeloma stem cells in vitro.…”

Section: 2mentioning

confidence: 88%

Mini–Midi–Maxi? How to harness the graft-versus-myeloma effect and target molecular remission after allogeneic stem cell transplantation

Kröger

2007

Leukemia

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Allogeneic stem cell transplantation in multiple myeloma after standard myeloablative conditioning induces a high rate of complete remissions, but long-term freedom from disease is achieved in 30-40% of the cases only. The therapeutic effect of allogeneic stem cell transplantation is due to cytotoxicity of high-dose chemotherapy and immune-mediated graft-versusmyeloma effect by donor T cells. Retrospective studies clearly suggest that both (a) reducing the intensity of high-dose chemotherapy by using reduced-intensity or non-myeloablative conditioning regimen or (b) reducing the immunotherapy of donor T cells by using T-cell depletion result in lower treatmentrelated morbidity and mortality, but also in higher rate of relapse. Therefore, this review will focus on potential strategies of how treatment-related morbidity and mortality might be kept low without an increased risk of relapse and how remission status after transplantation can be enhanced by using the newly established donor immunosystems after allografting as a platform for post-transplant treatment strategies with new drugs (thalidomide, lenalidomide, bortezomib) or immunotherapy (donor lymphocyte infusion, vaccination, tumor-specific T cells) in order to achieve remission on a molecular level, which seems to be a 'conditio sine qua non' to cure myeloma patients.

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Section: 2mentioning

confidence: 88%

Mini–Midi–Maxi? How to harness the graft-versus-myeloma effect and target molecular remission after allogeneic stem cell transplantation

Kröger

2007

Leukemia

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“…Although the same has been shown in the setting of autologous transplantation, [32][33][34] the meaning of CR in the allogeneic transplantation setting is distinct since the ultimate goal is longterm cure. This is underlined by data showing the prognostic Allogeneic transplantation in multiple myeloma S Gerull et al significance of reaching molecular remission, 35,36 and suggests that molecular monitoring should be considered after allogeneic transplantation. The role of allogeneic transplantation in the era of novel agents has been a subject of growing debate.…”

Section: Discussionmentioning

confidence: 99%

Allo-SCT for multiple myeloma in the era of novel agents: a retrospective study on behalf of Swiss Blood SCT

Gerull

Stangel

Aissa

et al. 2012

Bone Marrow Transplant

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Despite the introduction of novel drugs, cure of multiple myeloma remains rare. Allo-SCT can induce long-term remission, but randomized studies in advanced disease are lacking and the influence of novel drugs remains unclear. In our retrospective analysis of all patients with myeloma allografted in Switzerland, 95 patients were transplanted between 1988 and 2011. Most patients were heavily pre-treated, and 53% received novel drugs before transplant. In all, 51% were allografted after relapse or progression. Transplant trends changed over time with an increase in reduced intensity conditioning and unrelated donors. At the time of analysis 47 patients remained alive, with a median follow-up of survivors of 53 months. Acute GVHD II-IV and chronic GVHD (cGVHD) occurred in 49% and 53%, respectively; TRM at 5 years was 18%. Five-year OS and PFS were 51% and 29%, respectively. Patients who received transplant upfront vs after relapse had a significantly better outcome, as well as those who had a related donor and achieved CR post transplant. We found no impact of pre-treatment with novel drugs or cGVHD. Although long-term remission following allo-SCT can be achieved, GVHD and TRM remain major limitations. Our series suggests that benefit is highest when allo-SCT is used early in the disease.

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“…38 As an alternative, ASO realtime quantitative PCR provides an accurate quantification of residual disease, thus overcoming the problem. Several reports using this technique have been published, showing effective outcome discrimination in the transplant setting 29,[39][40][41][42][43] (Table 5). …”

Section: Novel Methods To Measure Mrdmentioning

confidence: 99%

Minimal residual disease testing after stem cell transplantation for multiple myeloma

Sherrod

Hari

Mosse

et al. 2015

Bone Marrow Transplant

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Prognostic role of minimal residual disease in multiple myeloma patients after non-myeloablative allogeneic transplantation

Cited by 56 publications

References 23 publications

Mini–Midi–Maxi? How to harness the graft-versus-myeloma effect and target molecular remission after allogeneic stem cell transplantation

Mini–Midi–Maxi? How to harness the graft-versus-myeloma effect and target molecular remission after allogeneic stem cell transplantation

Allo-SCT for multiple myeloma in the era of novel agents: a retrospective study on behalf of Swiss Blood SCT

Minimal residual disease testing after stem cell transplantation for multiple myeloma

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