Minimal Residual Disease in Multiple Myeloma
Menée sur 1 020 patients atteints d'un myélome multiple, cette étude évalue, du point de vue de la réponse complète et de la survie sans progression, la valeur pronostique de la présence d'une maladie résiduelle minimale détectée par cytométrie de flux à paramètres multiples après traitement d'induction ou greffe autologue de cellules souches
Progress in the treatment of multiple myeloma has increased extent and frequency of response, as well as prolonged progression free (PFS) and overall survival (OS). Randomized trials of high-dose therapy and autologous stem cell transplantation in the 1990s showed the latter to be superior to standard dose therapy and for the first time achieved complete responses.The advent of novel therapies in the past decade has further transformed treatment. In particular, immunomodulatory drugs (thalidomide/lenalidomide/pomalidomide)
and the proteasome inhibitors (bortezomib, carfilzomib), when combined as initial therapy for newly diagnosed patients, can achieve universal responses and complete responses (CRs) in a significant fraction of patients. Finally, the use of consolidation and maintenance therapy with novel agents can now further increaseCRrate and prolong duration of response.
Journal of Clinical Oncology , éditorial en libre accès, 2013