Zamagni Elena, Tacchetti Paola, Barbato Simona, Cavo Michele
Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Istituto di Ematologia "Seràgnoli", Università degli Studi, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
J Clin Med. 2020 Oct 31;9(11):3519. doi: 10.3390/jcm9113519.
The International Myeloma Working Group (IMWG) recently introduced the evaluation of minimal residual disease (MRD) within the multiple myeloma (MM) response criteria, and MRD negativity assessed inside and outside the bone marrow is currently considered the most powerful predictor of favorable long-term outcomes. However, MRD evaluation has thus far relied on flow-cytometry or molecular-based methods, despite the limitations associated with the patchy infiltration of bone marrow (BM) plasma cells and the presence of extra-medullary (EMD). On the contrary, imaging-based sensitive response assessment through the use of functional rather than morphological whole-body (WB) imaging techniques, such as positron emission tomography with computed tomography (PET/CT) and magnetic resonance imaging (MRI), likely is a promising strategy to overcome these limitations in evaluating response to therapy and in the assessment of the MRD status in MM patients. However, despite the significant advances in the development and availability of novel functional imaging techniques for MRD evaluation, a worldwide standardization of imaging criteria for acquisition, interpretation, and reporting is yet to be determined and will be object of future investigations.
国际骨髓瘤工作组（IMWG）最近在多发性骨髓瘤（MM）反应标准中引入了微小残留病（MRD）评估，目前认为骨髓内外评估的MRD阴性是长期良好预后的最有力预测指标。然而，尽管存在与骨髓（BM）浆细胞斑片状浸润和髓外疾病（EMD）相关的局限性，但迄今为止，MRD评估仍依赖于流式细胞术或基于分子的方法。相反，通过使用功能而非形态学的全身（WB）成像技术进行基于成像的敏感反应评估，如正电子发射断层扫描计算机断层扫描（PET/CT）和磁共振成像（MRI），可能是克服这些局限性以评估MM患者治疗反应和MRD状态的一种有前景的策略。然而，尽管用于MRD评估的新型功能成像技术在开发和可用性方面取得了重大进展，但用于采集、解读和报告的成像标准的全球标准化仍有待确定，将是未来研究的对象。
