Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission
Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
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MRD Negative Myeloma Induction?
If you reach MRD negative with induction therapy ONLY, what is your prognosis? That is to say, what is the average PFS and OS with a deep response to induction but no ASCT?
If you are a newly diagnosed MM patient (NDMM), uou may be wondering about the pros and cons of having an autologous stem cell transplant (ASCT).
According to studies, a growing number of standard-risk NDMM patients can achieve MRD negative status without having an ASCT. Because ASCT brings a lot of toxicity and possible side effects, many of these patients wonder how well they will do, on average, if they don’t have an ASCT. At least not upfront.
Is there any research that indicates the overall survival of newly diagnosed myeloma patients who achieve MRD negative status from induction therapy only?
Yes, several studies have demonstrated that achieving minimal residual disease (MRD) negativity after induction therapy in newly diagnosed multiple myeloma (NDMM) patients is associated with significantly improved survival outcomes.ASH Publications+2Cancer Research+2SpringerLink+2
Key Findings:
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Meta-Analysis Evidence: A comprehensive meta-analysis encompassing 44 studies with 8,098 patients found that MRD-negative status correlates with a 67% reduction in the risk of disease progression (hazard ratio [HR] 0.33) and a 55% reduction in the risk of death (HR 0.45) compared to MRD-positive patients. These benefits were consistent across various disease settings, including newly diagnosed and relapsed/refractory multiple myeloma, regardless of MRD assessment methods or cytogenetic risk profiles .PMC+1PubMed+1
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Timing of MRD Negativity: Research indicates that the timing of achieving MRD negativity impacts outcomes. Patients who attained MRD-negative status after induction therapy exhibited better progression-free survival (PFS) and overall survival (OS) compared to those who became MRD-negative after autologous stem cell transplant (ASCT) or maintenance therapy. Specifically, among patients achieving MRD negativity post-induction, only 8 experienced disease progression and 11 died during the follow-up period, underscoring the prognostic significance of early MRD negativity .Frontiers
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Real-World Data: A study analyzing real-world data found that NDMM patients achieving MRD negativity had a median PFS of 51 months versus 26 months for MRD-positive patients. Moreover, the median OS was not reached for MRD-negative patients, compared to 62 months for those who were MRD-positive, highlighting the substantial survival advantage conferred by MRD negativity .SpringerLink
Clinical Implications:
Achieving MRD negativity after induction therapy serves as a strong prognostic marker for improved survival in NDMM patients. This information can guide treatment decisions, such as the consideration of stem cell transplantation or maintenance therapy. However, it’s important to note that MRD negativity is not an absolute predictor of long-term remission, and ongoing monitoring remains essential.
What does it mean to be MRD negative?
I am a long-term MM survivor and cancer coach. There is a dizzying array of FDA approved MM treatments. NDMM patients often want to think about MM holistically.
This post is about maximizing the adage that “MM is not curable but very treatable.” Okay, what is the best treatment? How do I live the highest quality of life, the greatest quantity of life with the least amount of toxicity the lowest risk of side effects?
Email me at David.PeopleBeatingCancer@gmail.com to learn more about getting in shape (prehabilitating) to undergo MM therapy.
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Real-world prognostic significance of attaining minimal residual disease negativity in newly diagnosed multiple myeloma
“Abstract
The aim of the study was to evaluate the prognostic impact of minimal residual disease (MRD) in the real-world setting and the interaction between MRD and
- molecular risk,
- clinical response
- and autologous stem-cell transplant (ASCT).
A retrospective analysis of 275 newly diagnosed multiple myeloma (NDMM) patients who achieved very good partial remission (VGPR) or better before maintenance were involved.
We examined MRD status by multiparameter flow cytometry (MFC). At a median follow-up of 37 months (4–88 months), In patients who achieved ≥ VGPR, those with MRD negativity had significantly longer PFS (51 vs. 26 months; P < 0.001) and OS (Not reached: NR vs. 62 months, P < 0.001) than those with MRD positivity.
MRD positivity was the independent prognostic factor for PFS with hazard ratios of 2.650 (95% CI 1.755–4.033, P < 0.001) and OS with hazard ratios of 2.122 (95% CI 1.155–3.899, P = 0.015).
Achieving MRD negativity was able to ameliorate a poor prognosis associated with genetic high risk.
MRD negativity was associated with better PFS regardless of ASCT treatment. MRD status was more predictable for clinical outcome than conventional clinical responses. Moreover, Sustained MRD negativity ≥ 12 or ≥ 24 months improved both PFS and OS.
Patients with NDMM who achieved MRD-negative status or sustained MRD negativity had deep remission and improved clinical outcomes regardless of high-risk cytogenetics, ASCT and clinical responses in a real-world setting…”
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