Τίτλος:
Next generation flow cytometry for MRD detection in patients with AL amyloidosis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
The treatment of AL amyloidosis aims to eradicate the plasma cell clone and eliminate toxic free light chain production. Only in a minority of patients the plasma cell clone is completely eradicated; residual light chain production may still exist while clonal relapse may occur. We used sensitive next-generation flow cytometry (NGF) to detect minimal residual disease (MRD) in AL amyloidosis patients at complete haematologic response. MRD evaluation was feasible in 51 of 52 (98%) tested patients and at a median sensitivity of 2.3 × 10−6 MRD was undetectable in 23 (45%). An organ response occurred in 86% of MRDneg vs 77% in MRDpos; renal response in 15/17(88%) of MRDneg vs in 14/16(87.5%) of MRDpos and cardiac response in 10/10(100%) of MRDneg vs 11/15(73%) of MRDpos patients. After a median follow-up of 24 months post MRD testing, no MRDneg patient had a haematologic relapse vs 6/28(21%) MRDpos (p =.029). Pooling haematologic and organ progressions, 9 (32%) MRDpos patients had disease progression vs only 1 (4%) MRDneg patient (p =.026). In conclusion, MRD detection using NGF has profound clinical implications, so that AL patients with undetectable MRD have a very high probability of organ response and a very low probability of haematologic relapse. © 2020 Informa UK Limited, trading as Taylor & Francis Group.
Συγγραφείς:
Kastritis, E.
Kostopoulos, I.V.
Theodorakakou, F.
Fotiou, D.
Gavriatopoulou, M.
Migkou, M.
Tselegkidi, M.I.
Roussou, M.
Papathoma, A.
Eleutherakis-Papaioakovou, E.
Dialoupi, I.
Kanellias, N.
Ntalianis, A.
Rousakis, P.
Trougakos, I.P.
Tsitsilonis, O.
Gakiopoulou, C.
Terpos, E.
Dimopoulos, M.A.
Περιοδικό:
Amyloid: The Journal of Protein Folding Disorders
Εκδότης:
Taylor and Francis Ltd.
Λέξεις-κλειδιά:
bortezomib; brain natriuretic peptide; brain natriuretic peptide, adult; aged; AL amyloidosis; Article; B lymphocyte; bone marrow; clinical practice; controlled study; diagnostic test accuracy study; disease exacerbation; erythrocyte; erythroid precursor cell; female; flow cytometry; follow up; human; human tissue; major clinical study; male; mast cell; minimal residual disease; plasma cell; priority journal; proteinuria; sensitivity and specificity; AL amyloidosis; blood; bone marrow cell; complication; flow cytometry; middle aged; minimal residual disease; pathology; procedures; prognosis; ultrastructure, Adult; Aged; Bone Marrow Cells; Female; Flow Cytometry; Humans; Immunoglobulin Light-chain Amyloidosis; Male; Middle Aged; Natriuretic Peptide, Brain; Neoplasm, Residual; Plasma Cells; Prognosis
DOI:
10.1080/13506129.2020.1802713
