Beginning Myeloma Treatments Impact the Achievement of MRD-negative Goal
BY PAUL KLEUTGHEN The current issue of the Journal of Clinical Oncology reports more interesting research that, again, confirms the importance of achieving minimal residual disease (MRD) negative status in multiple myeloma treatment. This is an important topic that has already been presented earlier on this site. The focal point of the article was to point to the positive difference in progression free survival and overall survival for patients who achieved MRD-negative status. Of interest to note, however, is the embedded report of how different induction regimens impact the achievement of MRD-negative status. The authors report that 50% (out of + 600 patients studied) of those patients who underwent an induction regimen of VDT (Velcade, thalidomide, dexamethasone) followed by stem cell transplant achieved MRD-negative status. This compares to only 11 % for patients who were given an ‘older’ induction regimen named VBMCP/VBAD (vincristine, carmustine, cyclophosphamide, prednisone/vincristine, carmustine, doxorubicin and dexamethasone). There is no need to discuss these two regimens here, or for that matter, other induction regimens that are used in clinical practice these days. The point that we would like to make is that for the newly diagnosed patient is it well worth to pop the question “And what induction regimen is expected to give me the best chance to get me to MRD-negative status post-transplant ?” Let your myeloma specialist guide you through the options and their experience with outcomes so you can make an informed decision.