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000186679 1001_ $$00000-0002-6226-1252$$aMai, Elias K$$b0
000186679 245__ $$aImplications and prognostic impact of mass spectrometry in patients with newly-diagnosed multiple myeloma.
000186679 260__ $$aLondon [u.a.]$$bNature Publishing Group$$c2023
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000186679 520__ $$aMass spectrometry (MS) is a promising tool for monitoring monoclonal protein in plasma cell dyscrasias. We included 480 transplant-eligible newly-diagnosed multiple myeloma (MM) patients from the GMMG-MM5 trial (EudraCT No. 2010-019173-16) and performed a retrospective MS analysis at baseline (480 patients) and at the pre-defined, consecutive time points after induction (444 patients), prior to maintenance (305 patients) and after one year of maintenance (227 patients). We found that MS negativity was significantly associated with improved progression-free survival (PFS) even in patients with complete response (CR) at all investigated follow-up time points. The prognostic impact was independent of established risk factors, such as the revised International Staging System. Combining MS and baseline cytogenetics improved the prediction of outcome: MS-positive patients with high-risk cytogenetics had a dismal PFS of 1.9 years (95% confidence interval [CI]: 1.6-2.3 years) from the start of maintenance. Testing the value of sequential MS prior to and after one year of maintenance, patients converting from MS positivity to negativity had an excellent PFS (median not reached) while patients converting from MS negativity to positivity progressed early (median 0.6 years, 95% CI: 0.3-not reached). Among patients with sustained MS positivity, the baseline high-risk cytogenetic status had a significant impact and defined a group with poor PFS. Combining minimal residual disease (MRD) in the bone marrow and MS allowed the identification of double negative patients with a favorable PFS (median 3.33 years, 95% CI: 3.08-not reached) and no overall survival events. Our study provides strong evidence that MS is superior to conventional response monitoring, highlighting the potential of MS to become a new standard. Our data indicate that MS should be performed sequentially and combined with baseline disease features and MRD to improve its clinical value.Clinical Trials Register: EudraCT No. 2010-019173-16.
000186679 536__ $$0G:(DE-HGF)POF4-313$$a313 - Krebsrisikofaktoren und Prävention (POF4-313)$$cPOF4-313$$fPOF IV$$x0
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000186679 650_2 $$2MeSH$$aHumans
000186679 650_2 $$2MeSH$$aMultiple Myeloma: therapy
000186679 650_2 $$2MeSH$$aMultiple Myeloma: drug therapy
000186679 650_2 $$2MeSH$$aPrognosis
000186679 650_2 $$2MeSH$$aTreatment Outcome
000186679 650_2 $$2MeSH$$aRetrospective Studies
000186679 650_2 $$2MeSH$$aBone Marrow
000186679 650_2 $$2MeSH$$aNeoplasm, Residual: diagnosis
000186679 7001_ $$aHuhn, Stefanie$$b1
000186679 7001_ $$0P:(DE-He78)b97fc5666ea8f9db9ef499de6b2397cf$$aMiah, Kaya$$b2$$udkfz
000186679 7001_ $$aPoos, Alexandra M$$b3
000186679 7001_ $$aScheid, Christof$$b4
000186679 7001_ $$00000-0001-9422-6614$$aWeisel, Katja C$$b5
000186679 7001_ $$aBertsch, Uta$$b6
000186679 7001_ $$aMunder, Markus$$b7
000186679 7001_ $$aBerlanga, Oscar$$b8
000186679 7001_ $$aHose, Dirk$$b9
000186679 7001_ $$aSeckinger, Anja$$b10
000186679 7001_ $$aJauch, Anna$$b11
000186679 7001_ $$aBlau, Igor W$$b12
000186679 7001_ $$aHänel, Mathias$$b13
000186679 7001_ $$00000-0001-7803-0814$$aSalwender, Hans J$$b14
000186679 7001_ $$aBenner, Axel$$b15
000186679 7001_ $$aRaab, Marc S$$b16
000186679 7001_ $$aGoldschmidt, Hartmut$$b17
000186679 7001_ $$aWeinhold, Niels$$b18
000186679 773__ $$0PERI:(DE-600)2600560-8$$a10.1038/s41408-022-00772-9$$gVol. 13, no. 1, p. 1$$n1$$p1$$tBlood cancer journal$$v13$$x2044-5385$$y2023
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