Comparison of next-generation sequencing (NGS) and next-generation flow (NGF) for minimal residual disease (MRD) assessment in multiple myeloma
Alejandro Medina, Noemi Puig, Juan Flores-Montero, Cristina Jimenez, M-Eugenia Sarasquete, María Garcia-Alvarez, Isabel Prieto-Conde, Carmen Chillon, Miguel Alcoceba, Norma C Gutierrez, Albert Oriol, Laura Rosinol, Joan Bladè, Mercedes Gironella, Miguel T Hernandez , Veronica Gonzalez-Calle, Maria-Teresa Cedena, Bruno Paiva, Jesus F San-Miguel, Juan-Jose Lahuerta, Maria-Victoria Mateos, Joaquin Martinez-Lopez, Alberto Orfao, Marcos Gonzalez, Ramon Garcia-Sanz
Detecting persistent minimal residual disease (MRD) allows the identification of patients with an increased risk of relapse and death. In this study, we have evaluated MRD 3 months after transplantation in 106 myeloma patients using a commercial next-generation sequencing (NGS) strategy (LymphoTrack®), and compared the results with next-generation flow (NGF, EuroFlow).
The use of different marrow pulls and the need of concentrating samples for NGS biased the applicability for MRD evaluation and favored NGF. Despite that, correlation between NGS and NGF was high (R2 = 0.905). The 3-year progression-free survival (PFS) rates by NGS and NGF were longer for undetectable vs. positive patients (NGS: 88.7% vs. 56.6%; NGF: 91.4% vs. 50%; p < 0.001 for both comparisons), which resulted in a 3-year overall survival (OS) advantage (NGS: 96.2% vs. 77.3%; NGF: 96.6% vs. 74.9%, p < 0.01 for both comparisons). In the Cox regression model, NGS and NGF negativity had similar results but favoring the latter in PFS (HR: 0.20, 95% CI: 0.09-0.45, p < 0.001) and OS (HR: 0.21, 95% CI: 0.06-0.75, p = 0.02).
All these results reinforce the role of MRD detection by different strategies in patient prognosis and highlight the use of MRD as an endpoint for multiple myeloma treatment.
CITA DEL ARTÍCULO Blood Cancer J. 2020 Oct 30;10(10):108. doi: 10.1038/s41408-020-00377-0