Dual assessment with multiparameter flow cytometry and 18f-fdg pet/ct scan provides enhanced prediction of measurable residual disease after autologous haemopoietic stem cell transplant in myeloma—a prospective study

Access through your institution Buy or subscribe Measurable residual disease (MRD) is a surrogate endpoint for progression-free survival (PFS) in Multiple myeloma (MM) and meta analysis have

confirmed that bone marrow (BM) MRD negativity is associated with superior PFS both in transplant and non transplant setting [1]. BM next generation multiparametric flow cytometry (MFC) and

next generation sequencing (NGS) are currently being employed to assess MRD and have been included in the International Myeloma Working Group (IMWG) criteria for defining MRD negative state

[2]. 18F-FDG PET/CT scan with its ability to distinguish between metabolically active and inactive disease has helped to evaluate the extramedullary disease component which is present in up

to 20% of patients [3, 4]. We hypothesized that a combined assessment of MRD with BM flow and PET/CT scan may be more predictive and prospectively evaluated both on day + 100 post ASCT. In

addition, we also assessed the clinical and laboratory predictors of of flow MRD status and the risk factors influencing time to progression after transplant. Between April, 2016 and

November, 2019, 160 consecutive MM patients underwent first ASCT post novel agent based induction. Responses to induction and transplant were assessed using the IMWG consensus criteria. [2].

Post ASCT patients received maintenance therapy with lenalidomide 10 mg daily for 21 days every month for ≥2 years. The BM flow MRD was performed on 138 patients using previously described

protocol (supplementary File: Protocol) with an overall sensitivity of 10−6. Whole body 18F-FDG PET/CT after ASCT was done in 131 patients and the FDG uptake in the target lesions was

quantified according to the 5-point Deauville scale [5]. Four patients were PET negative at diagnosis as well as on day + 100 evaluation. The median interval from diagnosis to transplant was

12.1 months. The median follow up of the cohort is 39 months (range: 11 to 63.9 months). This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through

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clarity. Blood Rev. 2021;46:100732. https://doi.org/10.1016/j.blre.2020.100732. Article  CAS  PubMed  Google Scholar  Download references ACKNOWLEDGEMENTS We wish to thank all the patients

and their families for having participated in the study. We are also grateful to the resident doctors, laboratory and nursing staff, scientists and faculty of the departments of Medical

Oncology, Laboratory Oncology Unit and Nuclear Medicine. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi,

110029, India Anjali Mookerjee, Atul Sharma & Lalit Kumar * Lab Oncology, All India Institute of Medical Sciences, New Delhi, 110029, India Ritu Gupta * Nuclear Medicine, All India

Institute of Medical Sciences, New Delhi, 110029, India Rakesh Kumar * Bio-Statistics, All India Institute of Medical Sciences, New Delhi, 110029, India Ravindra Mohan Pandey Authors *

Anjali Mookerjee View author publications You can also search for this author inPubMed Google Scholar * Ritu Gupta View author publications You can also search for this author inPubMed 

Google Scholar * Rakesh Kumar View author publications You can also search for this author inPubMed Google Scholar * Atul Sharma View author publications You can also search for this author

inPubMed Google Scholar * Ravindra Mohan Pandey View author publications You can also search for this author inPubMed Google Scholar * Lalit Kumar View author publications You can also

search for this author inPubMed Google Scholar CONTRIBUTIONS AM: designing and performed the experiments, collating data, manuscript writing. RG: review of flow cytometry experiments/data,

discussion. RK: review of PET scan data. AS: patients clinical management RMP Statistical analysis. LK: conceptualization, experiments design, treatment and monitoring, manuscript writing

and editing. CORRESPONDING AUTHOR Correspondence to Lalit Kumar. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing interests. ADDITIONAL INFORMATION PUBLISHER’S NOTE

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Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Mookerjee, A., Gupta, R., Kumar, R. _et al._ Dual assessment with multiparameter flow cytometry and 18F-FDG PET/CT scan

provides enhanced prediction of measurable residual disease after autologous haemopoietic stem cell transplant in myeloma—a prospective study. _Bone Marrow Transplant_ 58, 1045–1047 (2023).

https://doi.org/10.1038/s41409-023-02017-0 Download citation * Received: 20 January 2023 * Revised: 14 May 2023 * Accepted: 07 June 2023 * Published: 16 June 2023 * Issue Date: September

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