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@ARTICLE{Mai:186679,
      author       = {E. K. Mai and S. Huhn and K. Miah$^*$ and A. M. Poos and C.
                      Scheid and K. C. Weisel and U. Bertsch and M. Munder and O.
                      Berlanga and D. Hose and A. Seckinger and A. Jauch and I. W.
                      Blau and M. Hänel and H. J. Salwender and A. Benner and M.
                      S. Raab and H. Goldschmidt and N. Weinhold},
      title        = {{I}mplications and prognostic impact of mass spectrometry
                      in patients with newly-diagnosed multiple myeloma.},
      journal      = {Blood cancer journal},
      volume       = {13},
      number       = {1},
      issn         = {2044-5385},
      address      = {London [u.a.]},
      publisher    = {Nature Publishing Group},
      reportid     = {DKFZ-2023-00048},
      pages        = {1},
      year         = {2023},
      abstract     = {Mass 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.},
      keywords     = {Humans / Multiple Myeloma: therapy / Multiple Myeloma: drug
                      therapy / Prognosis / Treatment Outcome / Retrospective
                      Studies / Bone Marrow / Neoplasm, Residual: diagnosis},
      cin          = {C060},
      ddc          = {610},
      cid          = {I:(DE-He78)C060-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:36599831},
      pmc          = {pmc:PMC9812999},
      doi          = {10.1038/s41408-022-00772-9},
      url          = {https://inrepo02.dkfz.de/record/186679},
}