Hematopathology Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Best Pract Res Clin Haematol. 2020 Mar;33(1):101154. doi: 10.1016/j.beha.2020.101154. Epub 2020 Feb 4.
Recent years saw significant breakthroughs in treatment of multiple myeloma. Durable remissions are now seen in a significant proportion of patients with the previously uniformly incurable and progressive disease. Yet because of deep suppression of the neoplastic myeloma clones by the newer therapies, older disease monitoring techniques are insufficient to distinguish between the patients at high risk of imminent relapse and those in whom durable remission is expected. This review briefly describes prognostic and therapeutic implications of measurable disease (MRD) evaluation, explains why deep MRD evaluation is needed for patients without morphologic evidence of disease, and reviews the state of the art of evaluation of myeloma MRD by flow cytometry.
近年来，多发性骨髓瘤的治疗取得了重大突破。以前无法治愈且病情不断恶化的疾病，现在有很大一部分患者能获得持久缓解。然而，由于新疗法对肿瘤骨髓瘤克隆的深度抑制，旧的疾病监测技术不足以区分那些有即将复发高风险的患者和那些有望获得持久缓解的患者。本文简要描述了可测量疾病（MRD）评估的预后和治疗意义，解释了为什么对于没有形态学疾病证据的患者需要进行深度 MRD 评估，并回顾了流式细胞术评估骨髓瘤 MRD 的最新技术。
