{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:56:50Z","timestamp":1788955010765,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"22","license":[{"start":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T00:00:00Z","timestamp":1698969600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The presence of minimal residual disease (MRD+) following autologous stem cell transplantation (ASCT) in multiple myeloma represents a poor prognostic factor for progression\u2010free survival (PFS) and overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>At our department, we recommend lenalidomide maintenance for patients who are MRD+ after ASCT, while MRD\u2010negative (MRD\u2212) patients, after information about the national guidelines, were not advised to follow this regimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of the total 228 patients, 175 received ASCT following first\u2010line induction (MRD\u2212 92 (53%), MRD+ 83 (47%), at 2\u2009months post\u2010ASCT), while 53 underwent ASCT after second\u2010line treatment (MRD\u2212 27 (51%), MRD+ 26 (49%), at the same time point). Comparatively, MRD\u2212 patients who did not receive maintenance demonstrated better OS than MRD+ patients who received upfront ASCT and maintenance treatment (96% vs. 86%, <jats:italic>p<\/jats:italic>\u2009=\u20090.030, at 3\u2009years). However, nonsignificant difference was found in PFS (76% vs. 62%, at 3\u2009years). Furthermore, second\u2010line ASCT, MRD\u2212 non\u2010maintained patients exhibited significantly better PFS than MRD+ (71% vs. 27%, <jats:italic>p<\/jats:italic>\u2009&gt;\u20090.001, at 3\u2009years). However, OS was better but nonsignificant (96% vs. 76%, at 3\u2009years). Fluorescence in\u00a0situ hybridization (FISH) analysis was performed on 141 out of the 228 patients. Of these, 85 (60%) patients were deemed standard risk (SR), and 56 (40%) were classified as high risk (HR). In the SR cohort, MRD\u2212 patients exhibited better PFS and OS than MRD+ patients (71% vs. 59% and 100% vs. 85%, respectively). In the HR cohort, the MRD\u2212 patients showed superior PFS but similar OS compared to MRD+ patients (66% vs. 42% and 81% vs. 80%, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results indicate that being MRD\u2212 is a more crucial prognostic factor for the 3\u2010year PFS and OS than the presence of high\u2010risk cytogenetic markers or undergoing maintenance treatment. The latter appears insufficient, particularly for MRD+ patients following ASCT in the second\u2010line setting, suggesting that these patients may require a more intensive treatment approach.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.6640","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T11:17:10Z","timestamp":1699010230000},"page":"20736-20744","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Minimal residual disease status is the prognostic determinant following high\u2010dose treatment for patients with multiple myeloma"],"prefix":"10.1002","volume":"12","author":[{"given":"Hareth","family":"Nahi","sequence":"first","affiliation":[{"name":"Department of Medicine Institution for biomedicine and clinical science  Link\u00f6ping Sweden"},{"name":"Center for Hematology and Regenerative Medicine, Department of Medicine, Huddinge Karolinska Institutet  Stockholm 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