Magnetic Resonance Imaging of Bone Marrow and its Results as a Criterion for Administration of Maintenance Therapy After Auto-HSCT in Multiple Myeloma Patients
Aim. To evaluate the efficacy of maintenance therapy in multiple myeloma (MM) patients after autologous hematopoietic stem cell transplantation (auto-HSCT) based on the results of MRI of bone marrow. Materials & Methods. The study included 32 MM patients aged 36 to 66 years (median 57 years)...
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Practical Medicine Publishing House
2018-10-01
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| Series: | Клиническая онкогематология |
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| Online Access: | http://bloodjournal.ru/wp-content/uploads/2018/09/11-1.pdf |
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| author | MV Solov’ev LP Mendeleeva GA Yatsyk NS Lutsik MV Firsova EG Gemdzhian VG Savchenko |
| author_facet | MV Solov’ev LP Mendeleeva GA Yatsyk NS Lutsik MV Firsova EG Gemdzhian VG Savchenko |
| author_sort | MV Solov’ev |
| collection | DOAJ |
| description | Aim. To evaluate the efficacy of maintenance therapy in multiple myeloma (MM) patients after autologous hematopoietic stem cell transplantation (auto-HSCT) based on the results of MRI of bone marrow.
Materials & Methods. The study included 32 MM patients aged 36 to 66 years (median 57 years) with complete remission after a single auto-HSCT. MRI of spine and pelvic bones was performed to identify the nature of bone marrow lesions and to determine the volume of tumor tissue on the day 100 after auto-HSCT. As maintenance therapy after auto-HSCT 14 patients received daily 15 mg lenalidomide in the period from day 1 to day 21 of the 28-day treatment course within 1 year. Monitoring of 18 patients was conducted without maintenance therapy. Statistical analysis included the assessment of progression-free survival (PFS) and relapse risk relationship to clinical and laboratory parameters.
Results. Twenty patients had a positive MRI (tumor volume > 1 cm3). Zero variation of MR signal in bone marrow and detection of a < 1 cm3 tumor were regarded as a negative MRI, which was the case in 12 patients. After reaching the negative MRI the best rates of 2-year PFS were registered: 100 % with maintenance therapy and 84 % without maintenance therapy. In patients with tumor load on MR scans the 2-year PFS significantly (p = 0.03) varied and accounted for 80 % in patients who received maintenance therapy vs. 33 % in patients without maintenance therapy. Administration of maintenance therapy after detecting residual tumor on MR scans on day 100 after auto-HSCT has a positive effect on PFS rates. Multivariate analysis confirmed the residual tumor on MR scans of bone marrow to be the most important parameter PFS depends on.
Conclusion. A negative MRI after auto-HSCT is a favourable prognostic factor determining a long-lasting (> 2 years) MM free period, despite the lack of maintenance therapy. |
| format | Article |
| id | doaj-art-b66402e25e1e4e71917cbb3c8cbcdd53 |
| institution | OA Journals |
| issn | 1997-6933 2500-2139 |
| language | Russian |
| publishDate | 2018-10-01 |
| publisher | Practical Medicine Publishing House |
| record_format | Article |
| series | Клиническая онкогематология |
| spelling | doaj-art-b66402e25e1e4e71917cbb3c8cbcdd532025-08-20T02:00:17ZrusPractical Medicine Publishing HouseКлиническая онкогематология1997-69332500-21392018-10-0111436036710.21320/2500-2139-2018-11-4-360-367Magnetic Resonance Imaging of Bone Marrow and its Results as a Criterion for Administration of Maintenance Therapy After Auto-HSCT in Multiple Myeloma PatientsMV Solov’ev0LP Mendeleeva1GA Yatsyk2NS Lutsik3MV Firsova4EG Gemdzhian5VG Savchenko6National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167Aim. To evaluate the efficacy of maintenance therapy in multiple myeloma (MM) patients after autologous hematopoietic stem cell transplantation (auto-HSCT) based on the results of MRI of bone marrow. Materials & Methods. The study included 32 MM patients aged 36 to 66 years (median 57 years) with complete remission after a single auto-HSCT. MRI of spine and pelvic bones was performed to identify the nature of bone marrow lesions and to determine the volume of tumor tissue on the day 100 after auto-HSCT. As maintenance therapy after auto-HSCT 14 patients received daily 15 mg lenalidomide in the period from day 1 to day 21 of the 28-day treatment course within 1 year. Monitoring of 18 patients was conducted without maintenance therapy. Statistical analysis included the assessment of progression-free survival (PFS) and relapse risk relationship to clinical and laboratory parameters. Results. Twenty patients had a positive MRI (tumor volume > 1 cm3). Zero variation of MR signal in bone marrow and detection of a < 1 cm3 tumor were regarded as a negative MRI, which was the case in 12 patients. After reaching the negative MRI the best rates of 2-year PFS were registered: 100 % with maintenance therapy and 84 % without maintenance therapy. In patients with tumor load on MR scans the 2-year PFS significantly (p = 0.03) varied and accounted for 80 % in patients who received maintenance therapy vs. 33 % in patients without maintenance therapy. Administration of maintenance therapy after detecting residual tumor on MR scans on day 100 after auto-HSCT has a positive effect on PFS rates. Multivariate analysis confirmed the residual tumor on MR scans of bone marrow to be the most important parameter PFS depends on. Conclusion. A negative MRI after auto-HSCT is a favourable prognostic factor determining a long-lasting (> 2 years) MM free period, despite the lack of maintenance therapy.http://bloodjournal.ru/wp-content/uploads/2018/09/11-1.pdfmultiple myelomamagnetic resonance imaging (MRI)autologous hematopoietic stem cell transplantation (auto-HSCT)maintenance therapyminimal residual disease |
| spellingShingle | MV Solov’ev LP Mendeleeva GA Yatsyk NS Lutsik MV Firsova EG Gemdzhian VG Savchenko Magnetic Resonance Imaging of Bone Marrow and its Results as a Criterion for Administration of Maintenance Therapy After Auto-HSCT in Multiple Myeloma Patients Клиническая онкогематология multiple myeloma magnetic resonance imaging (MRI) autologous hematopoietic stem cell transplantation (auto-HSCT) maintenance therapy minimal residual disease |
| title | Magnetic Resonance Imaging of Bone Marrow and its Results as a Criterion for Administration of Maintenance Therapy After Auto-HSCT in Multiple Myeloma Patients |
| title_full | Magnetic Resonance Imaging of Bone Marrow and its Results as a Criterion for Administration of Maintenance Therapy After Auto-HSCT in Multiple Myeloma Patients |
| title_fullStr | Magnetic Resonance Imaging of Bone Marrow and its Results as a Criterion for Administration of Maintenance Therapy After Auto-HSCT in Multiple Myeloma Patients |
| title_full_unstemmed | Magnetic Resonance Imaging of Bone Marrow and its Results as a Criterion for Administration of Maintenance Therapy After Auto-HSCT in Multiple Myeloma Patients |
| title_short | Magnetic Resonance Imaging of Bone Marrow and its Results as a Criterion for Administration of Maintenance Therapy After Auto-HSCT in Multiple Myeloma Patients |
| title_sort | magnetic resonance imaging of bone marrow and its results as a criterion for administration of maintenance therapy after auto hsct in multiple myeloma patients |
| topic | multiple myeloma magnetic resonance imaging (MRI) autologous hematopoietic stem cell transplantation (auto-HSCT) maintenance therapy minimal residual disease |
| url | http://bloodjournal.ru/wp-content/uploads/2018/09/11-1.pdf |
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