Ding Hong, Xu Juan, Lin Zhimei, Huang Jingcao, Wang Fangfang, Yang Yan, Cui Yushan, Luo Hongmei, Gao Yuhan, Zhai Xinyu, Pang Weicui, Zhang Li, Zheng Yuhuan
Department of Hematology, West China Hospital, and State Key Laboratory of Biotherapy and Cancer Center, Sichuan University, #37 GuoXue Xiang Street, Chengdu, China.
Department of Hematology, The Affiliated Hospital of Chengdu University, Chengdu, China.
Biomark Res. 2021 Oct 14;9(1):75. doi: 10.1186/s40364-021-00328-2.
Multiple myeloma (MM) is a treatable plasma cell cancer with no cure. Clinical evidence shows that the status of minimal residual disease (MRD) after treatment is an independent prognostic factor of MM. MRD indicates the depth of post-therapeutic remission. In this review article, we outlined the major clinical trials that have determined the prognostic value of MRD in MM. We also reviewed different methods that were used for MM MRD assessment. Most important, we reviewed our current understanding of MM MRD biology. MRD studies strongly indicate that MRD is not a uniform declination of whole MM tumor population. Rather, MM MRD exhibits unique signatures of cytogenetic aberration and gene expression profiles, unlike those of MM cells before therapy. Diagnostic high-risk MM and low-risk MM exhibited a diversity of MRD features. Clonal evaluation may occur at the MRD stage in MM. The dynamics from the diagnostic MM to MRD correlate with the disease prognosis. Lastly, on the aspect of omics, we performed data-based analysis to address the biological features underlying the course of diagnostic-to-MRD MM. To summarize, the MRD stage of disease represents a critical step in MM pathogenesis and progression. Demonstration of MM MRD biology should help us to deal with the curative difficulties.
多发性骨髓瘤（MM）是一种可治疗但无法治愈的浆细胞癌。临床证据表明，治疗后微小残留病（MRD）状态是MM的独立预后因素。MRD表明治疗后缓解的深度。在这篇综述文章中，我们概述了确定MRD在MM中预后价值的主要临床试验。我们还回顾了用于MM MRD评估的不同方法。最重要的是，我们回顾了目前对MM MRD生物学的理解。MRD研究强烈表明，MRD并非整个MM肿瘤群体的均匀下降。相反，MM MRD表现出独特的细胞遗传学异常特征和基因表达谱，与治疗前的MM细胞不同。诊断高危MM和低危MM表现出多种MRD特征。MM的MRD阶段可能会发生克隆评估。从诊断MM到MRD的动态变化与疾病预后相关。最后，在组学方面，我们进行了基于数据的分析，以探讨诊断MM到MRD病程背后的生物学特征。总之，疾病的MRD阶段代表了MM发病机制和进展中的关键步骤。对MM MRD生物学的论证应有助于我们应对治愈难题。
