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Recently, MRD negativity was approved as an early clinical endpoint for accelerated drug approval in MM. Nevertheless, there is limited evidence of MRD utility in real\u2010world setting. In this retrospective multicenter study, we report outcomes of 331 newly diagnosed MM patients with MRD evaluation at Day+100 after autologous stem cell transplantation using flow cytometry with a median limit of detection of 0.001%. MRD negativity was reached in 47% of patients and was associated with significantly prolonged median PFS (49.2\u2009months vs. 18.4\u2009months; hazard ratios (HR)\u2009=\u20090.37;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and OS (not reached vs. 74.9\u2009months; HR\u2009=\u20090.50;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.007). Achieving MRD negativity was associated with PFS improvements regardless of age, International Staging System (ISS) stage, lactate dedydrogenase (LDH) level, or cytogenetic risk. Importantly, MRD positive patients benefited from lenalidomide maintenance versus no maintenance (18\u2010months PFS: 81% vs. 46%; HR\u2009=\u20090.24;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002) while in MRD negative patients such benefit was not observed (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.747). The outcomes of our real\u2010world study recapitulate results from clinical trials including meta\u2010analyses and support the idea that MRD positive patients profit more from lenalidomide maintenance than MRD negative ones.\n                  <\/jats:p>","DOI":"10.1111\/ejh.14316","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T02:59:25Z","timestamp":1728615565000},"page":"155-163","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Real\u2010World Evidence on Prognostic Value of\n                    <scp>MRD<\/scp>\n                    in Multiple Myeloma Using Flow Cytometry"],"prefix":"10.1111","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8589-1577","authenticated-orcid":false,"given":"Ludmila","family":"Muronova","sequence":"first","affiliation":[{"name":"Department of Hematooncology University Hospital Ostrava  Ostrava Czech 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Hematooncology University Hospital Ostrava  Ostrava Czech Republic"},{"name":"Department of Hematooncology, Faculty of Medicine University of Ostrava  Ostrava Czech Republic"},{"name":"Department of Biology and Ecology, Faculty of Science University of Ostrava  Ostrava Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tereza","family":"Popkova","sequence":"additional","affiliation":[{"name":"Department of Hematooncology University Hospital Ostrava  Ostrava Czech Republic"},{"name":"Department of Hematooncology, Faculty of Medicine University of Ostrava  Ostrava Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Plonkova","sequence":"additional","affiliation":[{"name":"Department of Hematooncology University Hospital Ostrava  Ostrava Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ondrej","family":"Venglar","sequence":"additional","affiliation":[{"name":"Department of Hematooncology University Hospital Ostrava  Ostrava Czech Republic"},{"name":"Department of Hematooncology, Faculty of Medicine University of Ostrava  Ostrava Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludek","family":"Pour","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine Masaryk University  Brno Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7072-8537","authenticated-orcid":false,"given":"Martin","family":"Stork","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine Masaryk University  Brno Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Rihova","sequence":"additional","affiliation":[{"name":"Department of Clinical Hematology 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General Teaching Hospital Charles University  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Spacek","sequence":"additional","affiliation":[{"name":"1st Medical Department\u2014Clinical Department of Haematology of the First Faculty of Medicine and General Teaching Hospital Charles University  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimira","family":"Rezacova","sequence":"additional","affiliation":[{"name":"Institute of Clinical Immunology and Allergology, Faculty of Medicine University Hospital and Charles University  Hradec Kralove Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Maisnar","sequence":"additional","affiliation":[{"name":"4th Department of Internal Medicine\u2014Hematology University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove  Hradec Kralove Czech 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