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<p>Measurable residual disease (MRD) negativity is a validated prognostic marker in multiple myeloma, though most evidence derives from clinical trials using highly sensitive platforms not routinely available worldwide. Real-world data on conventional multiparametric flow cytometry (MFC)-based MRD assessment remain limited. This retrospective single-center study included 91 newly-diagnosed multiple myeloma patients. MRD was assessed by MFC at 10⁻⁴ sensitivity using an 8-color antibody panel after first-line therapy and two months post-autologous stem cell transplantation(ASCT) in patients achieving very good partial response or better. Bone marrow samples with minimum 500,000 acquired events were analyzed. Survival outcomes were evaluated using Kaplan-Meier analysis and Cox proportional hazards models. Among 70 patients evaluated pre-transplant, 55.7% were MRD-negative. Post-ASCT, 58.1% of 62 transplanted patients achieved MRD negativity. Pre-transplant MRD status showed a non-significant trend toward longer progression-free survival (PFS) (42.3 vs. 31.5 months, <i>p</i> = 0.0609). Post-ASCT MRD positivity was significantly associated with worse outcomes: median overall survival (OS) was 48.3 versus 89.6 months (<i>p</i> = 0.0065) and median PFS was 26.4 versus 51.7 months (<i>p</i> = 0.0091) in MRD-positive versus MRD-negative patients, respectively. The overall cohort median OS was 72.3 months and median PFS was 38.6 months. MFC-based MRD assessment at 10⁻⁴ sensitivity demonstrated significant prognostic value in the post-ASCT setting within a real-world cohort, despite treatment heterogeneity and limited sample size. These findings support the clinical utility of accessible MRD assays in resource-limited settings and highlight the need for standardized, broadly implementable MRD assessment strategies to guide treatment decisions and improve global patient outcomes.</p>

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Flow Cytometric MRD Analysis and Survival in Multiple Myeloma: A Single-Center Real-Life Cohort Study

  • 期刊论文

  • 发表日期：

    2026年6月29日

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  • Emre Akar,
  • Şüheda Çakmak,
  • Mehmet Baysal,
  • Seval Akpınar,
  • Burhan Turgut

摘要

Measurable residual disease (MRD) negativity is a validated prognostic marker in multiple myeloma, though most evidence derives from clinical trials using highly sensitive platforms not routinely available worldwide. Real-world data on conventional multiparametric flow cytometry (MFC)-based MRD assessment remain limited. This retrospective single-center study included 91 newly-diagnosed multiple myeloma patients. MRD was assessed by MFC at 10⁻⁴ sensitivity using an 8-color antibody panel after first-line therapy and two months post-autologous stem cell transplantation(ASCT) in patients achieving very good partial response or better. Bone marrow samples with minimum 500,000 acquired events were analyzed. Survival outcomes were evaluated using Kaplan-Meier analysis and Cox proportional hazards models. Among 70 patients evaluated pre-transplant, 55.7% were MRD-negative. Post-ASCT, 58.1% of 62 transplanted patients achieved MRD negativity. Pre-transplant MRD status showed a non-significant trend toward longer progression-free survival (PFS) (42.3 vs. 31.5 months, p = 0.0609). Post-ASCT MRD positivity was significantly associated with worse outcomes: median overall survival (OS) was 48.3 versus 89.6 months (p = 0.0065) and median PFS was 26.4 versus 51.7 months (p = 0.0091) in MRD-positive versus MRD-negative patients, respectively. The overall cohort median OS was 72.3 months and median PFS was 38.6 months. MFC-based MRD assessment at 10⁻⁴ sensitivity demonstrated significant prognostic value in the post-ASCT setting within a real-world cohort, despite treatment heterogeneity and limited sample size. These findings support the clinical utility of accessible MRD assays in resource-limited settings and highlight the need for standardized, broadly implementable MRD assessment strategies to guide treatment decisions and improve global patient outcomes.