Minimal residual disease in multiple myeloma: current status

Area of Science:

• Hematology
• Oncology
• Molecular Biology

Background:

• Multiple myeloma (MM) is a treatable but incurable plasma cell cancer.
• Minimal residual disease (MRD) status post-treatment is an independent prognostic factor in MM.
• MRD assessment reflects the depth of remission achieved after therapy.

Purpose of the Study:

• To review clinical trials establishing the prognostic value of MRD in MM.
• To survey diverse methods used for MM MRD assessment.
• To elucidate the unique biology of MM MRD.

Main Methods:

• Review of major clinical trials on MRD prognostic value in MM.
• Analysis of various MM MRD assessment methodologies.
• Data-based analysis of omics data to understand diagnostic-to-MRD MM progression.

Main Results:

• MM MRD is not a uniform decline but exhibits distinct cytogenetic and gene expression profiles.
• MRD features vary between diagnostic high-risk and low-risk MM.
• Clonal evolution can occur at the MRD stage, correlating with prognosis.

Conclusions:

• The MRD stage is critical in MM pathogenesis and progression.
• Understanding MM MRD biology is essential for overcoming challenges in achieving a cure.
• Dynamics from diagnostic MM to MRD provide prognostic insights.