Minimal Residual Disease Assessment by Flow Cytometry in Multiple Myeloma After Receiving Triple Combination Therapy

Abstract

This study aimed to measure minimal residual disease for fifty newly diagnosed multiple myeloma patients after receiving triple combination therapy who achieved complete response by multiparameter flow cytometry and correlate with clinical and laboratory data of the patients. Most of patients included at the study were males with mean age about 56 years old and most of them were
score 2 performance score. Regard disease characteristic about (58%)29 patients were anemic. Most of patients were normal renal function (62%)31 patients. About (20%)10 patients were high calcium level. Serum protein electrophoresis and immunofixation done and about (64%)32 patients were IgG. About (66%) 33 patients were with multiple bone lesions. Patients characteristic either age, sex and performance statues have no effect on MRD result of patients with newly diagnosed MM. There was significant association between B2M level and MRD result and the P Value was (0.010), high level was associated with more MRD positivity. Also there was significant association between ISS and MRD result. As regard patient with low risk ISS (64.7%) 11 patients achieved negative MRD,
patients with high risk ISS (17.6%) 3 patients only achieved negative MRD and the p value was significant about (0.020). But there was no significant association between LDH level and MRD results. There were more MRD negativity with patients who received VRD protocol but was not significant so either VCD or VRD protocol is accepted for induction therapy regarding renal function. There was discordant between complete response and MRD result after induction therapy. Although all patient included achieved complete remission after induction therapy but only about one third of patients were negative MRD. This study included fifty newly diagnosed multiple myeloma patients was carried out at Clinical Oncology and Hematology Departments at Tanta and Alexandria Universities at the period from august 2022 to June 2023.