Yanamandra Uday, Kumar Shaji K
a Department of Hematology and Stem Cell Transplant , Army Hospital - Research and Referral , New Delhi , India.
b Department of Internal Medicine, Division of Hematology , Mayo Clinic , Rochester , MN , USA.
Leuk Lymphoma. 2018 Aug;59(8):1772-1784. doi: 10.1080/10428194.2017.1386304. Epub 2017 Oct 11.
The primary hurdle in the path to curing multiple myeloma (MM) is defining a validated minimal residual disease (MRD) and its utility in the therapeutic decision making. A better definition of MRD will aid in tailoring MM therapy further to address the clonal heterogeneity and genomic instability and overcome patient's ineffective immune surveillance. MRD analysis can define the logical endpoint for maintenance therapy, in addition also aids in providing a better clinical end point for studies comparing novel agents in myeloma. MRD is a surrogate for the survival in MM. Guidelines for global incorporation of MRD in myeloma are fraught with lack of standardization, universal availability and abridged physicians' understanding of MRD modalities. We aimed at addressing some of the frequently asked questions in the MRD assessment and will also place in perspective some arguments in favor of MRD assessment in routine practice and clinical trial scenario.
治愈多发性骨髓瘤（MM）道路上的主要障碍是确定经过验证的微小残留病（MRD）及其在治疗决策中的作用。对MRD进行更好的定义将有助于进一步调整MM治疗方案，以应对克隆异质性和基因组不稳定性，并克服患者无效的免疫监视。MRD分析可以确定维持治疗的合理终点，此外还有助于为比较骨髓瘤新型药物的研究提供更好的临床终点。MRD是MM生存情况的一个替代指标。将MRD全面纳入骨髓瘤治疗的指南存在缺乏标准化、普遍可及性以及医生对MRD模式理解不足等问题。我们旨在解答MRD评估中一些常见问题，并阐述在常规实践和临床试验中支持MRD评估的一些观点。
