Abstract
Purpose
To assess the feasibility and prognostic value of minimal residual disease (MRD) evaluated by multiparameter flow cytometry (MFC) in newly diagnosed amyloid light chain (AL) amyloidosis.
Methods
Clinical data from 25 consecutive newly diagnosed AL amyloidosis patients with MRD data tested at 3 months after first-line therapy completion were retrospectively analysed in a single centre from 2012 to 2019. First-line therapy included 8 courses of VD or 4 courses of VD plus sequential autologous stem cell transplantation (ASCT), both without maintenance therapy.
Results
Of 25 patients with very good partial response (VGPR) or better, 19 (76%) achieved MRD negativity. Baseline characteristics were not different between MRD-negative and MRD-positive patients. More ASCT patients than non-ASCT patients (90.0% vs 53.3%, p = 0.043) achieved MRD negativity. In the MRD-negative and MRD-positive groups, cardiac response was observed in 93% and 25% (p = 0.019) and any organ response in 94% and 50%, respectively (p = 0.023). At a median follow-up of 25.1 months, MRD-negative patients showed significantly longer progression-free survival (PFS) from diagnosis than MRD-positive patients (24.52 vs 76.39 months, p = 0.004).
Conclusions
MRD negativity measured by MFC at 3 months after first-line therapy completion in patients with AL amyloidosis is measurable and associated with improved organ response rates and PFS over a long follow-up.
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We thank the research staff for recruiting patients to the study and for their involvement in patient recruitment, data collection, and data management.
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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by BH, JL, MC and JG. The first draft of the manuscript was written by JL and XL and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Li, X., Huang, B., Liu, J. et al. Clinical value of minimal residual disease assessed by multiparameter flow cytometry in amyloid light chain amyloidosis. J Cancer Res Clin Oncol 148, 913–919 (2022). https://doi.org/10.1007/s00432-021-03653-z
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DOI: https://doi.org/10.1007/s00432-021-03653-z