Implications of detecting serum monoclonal protein by MASS-fix following stem cell transplantation in multiple myeloma

Br J Haematol. 2021 Apr;193(2):380-385. doi: 10.1111/bjh.17195. Epub 2020 Nov 20.

Abstract

Measurable residual disease (MRD) assessment by marrow-based next-generation flow cytometry (NGF) following autologous stem cell transplantation (ASCT) may lead to false-negative results due to patchy marrow involvement and extramedullary disease in patients with multiple myeloma. We assessed the value of simultaneous MRD evaluation with NGF and serum matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MASS-FIX). Of all 61 complete responders who were NGF-negative for MRD, around day-100 post ASCT, 59% were MASS-FIX-positive. At median follow-up of 26 months, 69% of MASS-FIX(+)/NGF(-) patients were alive and progression-free versus 96% of MASS-FIX(-)/NGF(-) patients, P = 0·02. MASS-FIX, a simple peripheral blood-based assay complements marrow-based NGF to accurately prognosticate patients with myeloma.

Keywords: mass spectroscopy; measurable residual disease; prognosis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bone Marrow / metabolism
  • False Negative Reactions
  • Female
  • Flow Cytometry / methods
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Immunoglobulin Subunits / blood
  • Male
  • Middle Aged
  • Multiple Myeloma / diagnosis*
  • Multiple Myeloma / pathology
  • Multiple Myeloma / therapy*
  • Neoplasm, Residual / blood*
  • Neoplasm, Residual / diagnosis
  • Paraproteinemias / blood*
  • Prognosis
  • Progression-Free Survival
  • Retrospective Studies
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / methods

Substances

  • Immunoglobulin Subunits