Bone marrow based minimal residual disease (MRD) assessments provide greater sensitivity for residual disease detection compared to the standard serological techniques and MRD negativity is associated with improved progression-free survival (PFS). However, the frequency at which MRD can be assessed is limited by the invasive nature and cost of the current assays. These assays may also give false negative results due to the heterogeneous nature of marrow involvement in multiple myeloma and extramedullary disease. Mass spectrometry (MS) methodologies are emerging as a more sensitive way of monitoring monoclonal proteins in the peripheral blood. In this study we assessed the prognostic impact of detectable residual monoclonal FLC by matrix-assisted laser desorption ionisation-time of flight (MALDI-TOF) MS in patients with transplant-eligible newly diagnosed multiple myeloma.

Conclusions

MS provided additional sensitivity for residual disease detection in patients in CR and positivity was associated with reduced PFS. MS also added additional prognostic information for patients who were MRD negative during maintenance with residual positivity being associated with an increased risk of early relapse.

ASH 2021: Abstract 820