Rihova L, Vsianska P, Bezdekova R, Kralova R, Penka M, Krejci M, Pour L, Hájek R
Klin Onkol. 2017 Summer;30(Supplementum2):21-28. doi: 10.14735/amko20172S21.
Progress in treatment of multiple myeloma extensively increased patient remission rates, so minimal residual disease (MRD) detection becomes essential to assess the effectivity of treatment and depth of complete response. Nowadays, multiparametric flow cytometry (MFC) is the most used method for monitoring of MRD presence in the bone marrow of multiple myeloma patients; however, detection on molecular level can be used as well. It is evident that choice of protocol used for MFC-MRD assessment can significantly affect required results; nevertheless, standardized and highly sensitive approach of "next generation flow" is already available. Although benefit of MRD assessment as an independent predictor of progression-free survival and overall survival is known, very recent research showed that MRD-negative status surpasses the prognostic value of complete response achievement for progression-free survival and overall survival.
This review is focused on use MFC in MRD assessment in multiple myeloma. The technical aspects and clinical benefits of this approach are mentioned as well.
The information about MRD level detected by highly sensitive and reproducible MFC can be potentially used as a biomarker to evaluate the efficacy of different treatment strategies, help on treatment decisions and act as a surrogate for overall survival in multiple myeloma patients.Key words: multiple myeloma - minimal residual disease - flow cytometry - plasma cells.
多发性骨髓瘤治疗的进展大幅提高了患者的缓解率，因此检测微小残留病（MRD）对于评估治疗效果和完全缓解深度至关重要。如今，多参数流式细胞术（MFC）是监测多发性骨髓瘤患者骨髓中MRD存在情况最常用的方法；然而，分子水平的检测也可采用。显然，用于MFC-MRD评估的方案选择会显著影响所需结果；尽管如此，“新一代流式”的标准化且高度灵敏的方法已然可用。虽然已知MRD评估作为无进展生存期和总生存期的独立预测指标具有益处，但最近的研究表明，MRD阴性状态在无进展生存期和总生存期方面超过了达到完全缓解的预后价值。
本综述聚焦于MFC在多发性骨髓瘤MRD评估中的应用。还提及了该方法的技术层面和临床益处。
通过高度灵敏且可重复的MFC检测到的MRD水平信息，有可能用作生物标志物来评估不同治疗策略的疗效，辅助治疗决策，并作为多发性骨髓瘤患者总生存期的替代指标。关键词：多发性骨髓瘤 - 微小残留病 - 流式细胞术 - 浆细胞
