Assessment of minimal residual disease using multiparametric flow cytometry in patients with AL amyloidosis.

Blood Advances
Andrew StaronVaishali Sanchorawala

Abstract

Despite achieving a hematologic complete response after treatment, many patients with AL amyloidosis do not attain recovery of organ function and/or experience hematologic relapse. A persistent plasma cell clone producing amyloidogenic light chains at levels below the detection threshold of traditional serologic methods is hypothesized to impede organ response in some patients. Assessment of minimal residual disease (MRD) may therefore have clinical importance as a more stringent treatment response tool for patients in a hematologic complete response. We used 2-tube, 10-color combination multiparametric flow cytometry to assess for MRD at a minimum sensitivity of 1 in 105 nucleated cells. Of 65 patients in hematologic complete response, 36 (55%) were found to have a residual clonal plasma cell population in the bone marrow. Comparing the MRD-negative and MRD-positive groups, renal response was observed in 88% vs 64% (P = .06), cardiac response in 75% vs 59% (P = .45), and any organ response in 90% vs 75% (P = .20) of patients. Depth of organ response as measured by the percent decrease in 24-hour proteinuria and brain natriuretic peptide was 96% vs 91% (P = .16) and 55% vs 46% (P = .66), respectively. These data suggest a possi...Continue Reading

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Citations

Sep 23, 2020·Cytometry. Part B, Clinical Cytometry·Andrea EspasaMarc Sorigue
Aug 6, 2020·Frontiers in Pharmacology·Alice NevoneMario Nuvolone
Dec 5, 2020·Hematology·Giovanni PalladiniGiampaolo Merlini
Dec 4, 2020·Blood·Giovanni PalladiniGiampaolo Merlini
Apr 9, 2021·British Journal of Haematology·Susan Bal, Morie A Gertz
May 10, 2021·Journal of Cancer Research and Clinical Oncology·Xiaozhe LiJuan Li
May 20, 2021·The New England Journal of Medicine·Nelson LeungSamih H Nasr
Jun 23, 2021·Blood Cancer Journal·Shayna SarosiekVaishali Sanchorawala
Aug 6, 2021·Blood Cancer Journal·Andrew StaronVaishali Sanchorawala
Sep 15, 2021·Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis·Alfonso Rivera DuarteVishal Kukreti
Jun 15, 2020·Acta Haematologica·Foteini TheodorakakouEfstathios Kastritis
Jun 23, 2020·Acta Haematologica·Tobias DittrichStefan O Schönland

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