Rawstron Andy C, Gregory Walter M, de Tute Ruth M, Davies Faith E, Bell Sue E, Drayson Mark T, Cook Gordon, Jackson Graham H, Morgan Gareth J, Child J Anthony, Owen Roger G
St James's University Hospital, Leeds, United Kingdom;
University of Leeds, Leeds, United Kingdom;
Blood. 2015 Mar 19;125(12):1932-5. doi: 10.1182/blood-2014-07-590166. Epub 2015 Feb 2.
The detection of minimal residual disease (MRD) in myeloma using a 0.01% threshold (10(-4)) after treatment is an independent predictor of progression-free survival (PFS), but not always of overall survival (OS). However, MRD level is a continuous variable, and the predictive value of the depth of tumor depletion was evaluated in 397 patients treated intensively in the Medical Research Council Myeloma IX study. There was a significant improvement in OS for each log depletion in MRD level (median OS was 1 year for ≥10%, 4 years for 1% to <10%, 5.9 years for 0.1% to <1%, 6.8 years for 0.01% to <0.1%, and more than 7.5 years for <0.01% MRD). MRD level as a continuous variable determined by flow cytometry independently predicts both PFS and OS, with approximately 1 year median OS benefit per log depletion. The trial was registered at www.isrctn.com as #68454111.
在骨髓瘤中，治疗后采用0.01%（10⁻⁴）阈值检测微小残留病（MRD）是无进展生存期（PFS）的独立预测指标，但并非总生存（OS）的独立预测指标。然而，MRD水平是一个连续变量，在医学研究委员会骨髓瘤IX研究中，对397例接受强化治疗的患者评估了肿瘤清除深度的预测价值。MRD水平每降低一个对数，OS就有显著改善（MRD≥10%时，中位OS为1年；1%至<10%时，为4年；0.1%至<1%时，为5.9年；0.01%至<0.1%时，为6.8年；MRD<0.01%时，超过7.5年）。通过流式细胞术确定的作为连续变量的MRD水平可独立预测PFS和OS，每降低一个对数，中位OS获益约1年。该试验在www.isrctn.com上注册，注册号为#68454111。
