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High-risk cytogenetics and persistent minimal residual disease by multiparameter flow cytometry predict unsustained complete response after autologous stem cell transplantation in multiple myeloma

  作者 Paiva, B; Gutierrez, NC; Rosinol, L; Vidriales, MB; Montalban, MA; Martinez-Lopez, J; Mateos, MV; Cibeira, MT; Cordon, L; Oriol, A; Terol, MJ; Echeveste, MA; de Paz, R; de Arriba, F; Palomera, L; de la Rubia, J; Diaz-Mediavilla, J; Sureda, A; Gorosquieta, A; Alegre, A; Martin, A; Hernandez, MT; Lahuerta, JJ; Blade, J; Migue, JFS  
  选自 期刊  Blood;  卷期  2012年119-3;  页码  687-691  
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[摘要]The achievement of complete response (CR) after high-dose therapy/autologous stem cell transplantation (HDT/ASCT) is a surrogate for prolonged survival in multiple myeloma; however, patients who lose their CR status within 1 year of HDT/ASCT (unsustained CR) have poor prognosis. Thus, the identification of these patients is highly relevant. Here, we investigate which prognostic markers can predict unsustained CR in a series of 241 patients in CR at day +100 after HDT/ASCT who were enrolled in the Spanish GEM2000 (n = 140) and GEM2005 < 65y (n = 101) trials. Twenty-nine (12%) of the 241 patients showed unsustained CR and a dismal outcome (median overall survival 39 months). The presence of baseline high-risk cytogenetics by FISH (hazard ratio 17.3; P = .002) and persistent minimal residual disease by multiparameter flow cytometry at day +100 after HDT/ASCT (hazard ratio 8.0; P = .005) were the only independent factors that predicted unsustained CR. Thus, these 2 parameters may help to identify patients in CR at risk of early progression after HDT/ASCT in whom novel treatments should be investigated. (Blood.2012;119(3):687-691)

 
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