{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:17:07Z","timestamp":1790381827086,"version":"4.1.0"},"reference-count":35,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010256","name":"Guangzhou Municipal Science and Technology Project","doi-asserted-by":"crossref","award":["2025A04J5219"],"award-info":[{"award-number":["2025A04J5219"]}],"id":[{"id":"10.13039\/501100010256","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82470197"],"award-info":[{"award-number":["82470197"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82270209"],"award-info":[{"award-number":["82270209"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"award":["82470197"],"award-info":[{"award-number":["82470197"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]},{"award":["82270209"],"award-info":[{"award-number":["82270209"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: The optimal duration of maintaining minimal residual disease (MRD) negative status remains unclear in transplant-eligible newly diagnosed multiple myeloma (TE-NDMM). This single-center retrospective study aimed to explore the minimum duration of sustained MRD negativity with prognostic value. Methods: This research included 223 TE-NDMM patients who achieved at least two consecutive MRD-negative assessments after initial treatment. We analyzed the influence of sustained MRD negativity on survival in different risk stratifications. Results: There was no difference in progression-free survival (PFS) between high-risk (HR) patients with an MRD negativity duration of \u22652 years and patients in the standard-risk (SR) group (70.77 vs. 67.38 months, p = 0.529). In SR patients, PFS showed no significant difference between patients maintaining MRD negativity for 2\u20133 years and those maintaining MRD negativity for more than 3 years (72.25 months vs. 107.50 months, p = 0.103). In contrast, in the HR group, there was no difference between a duration of 4\u20135 years and \u22655 years (NR vs. 84.53 months, p = 0.136). A duration over 2 years was associated with superior overall survival (OS) for all patients. Conclusions: Long-term maintenance of MRD-negative status was associated with good prognosis. Sustained MRD negativity for \u22652 years was associated with reducing the adverse influence of high-risk cytogenetics, and a duration over 4 years may be correlated with longer PFS in high-risk multiple myeloma patients in an exploratory analysis based on limited cases.<\/jats:p>","DOI":"10.3390\/cancers18101569","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T12:33:37Z","timestamp":1778589217000},"page":"1569","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sustained MRD Negative for 4 Years Is a Significant Marker of Prognosis in Patients with High-Risk Multiple Myeloma"],"prefix":"10.3390","volume":"18","author":[{"given":"Huan","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5878-9293","authenticated-orcid":false,"given":"Meilan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaozhe","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifen","family":"Kuang","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingxia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6685-4046","authenticated-orcid":false,"given":"Yanjuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0909-4731","authenticated-orcid":false,"given":"Juan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1001\/jama.2022.0003","article-title":"Diagnosis and Management of Multiple Myeloma: A Review","volume":"327","author":"Cowan","year":"2022","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/S0140-6736(21)00135-5","article-title":"Multiple myeloma","volume":"397","author":"Pawlyn","year":"2021","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1007\/s11899-021-00633-5","article-title":"MRD Assessment in Multiple Myeloma: Progress and Challenges","volume":"16","author":"Bertamini","year":"2021","journal-title":"Curr. Hematol. Malig. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1038\/s41571-025-01017-x","article-title":"Opportunities and challenges for MRD assessment in the clinical management of multiple myeloma","volume":"22","author":"Paiva","year":"2025","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e70270","DOI":"10.1002\/cam4.70270","article-title":"Clinical Outcome of Induction Treatment in the Era of Novel Agents and the Impact of the Number of High-Risk Cytogenetic Abnormalities (HRA) on Prognosis of Patients with Newly Diagnosed Multiple Myeloma (NDMM): Insights From a Multicenter Study","volume":"13","author":"Liang","year":"2024","journal-title":"Cancer Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1182\/blood-2011-09-379164","article-title":"Administration of bortezomib before and after autologous stem cell transplantation improves outcome in multiple myeloma patients with deletion 17p","volume":"119","author":"Neben","year":"2012","journal-title":"Blood"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2901","DOI":"10.1200\/JCO.21.01935","article-title":"Daratumumab, Carfilzomib, Lenalidomide, and Dexamethasone with Minimal Residual Disease Response-Adapted Therapy in Newly Diagnosed Multiple Myeloma","volume":"40","author":"Costa","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5988","DOI":"10.1182\/bloodadvances.2020002827","article-title":"A large meta-analysis establishes the role of MRD negativity in long-term survival outcomes in patients with multiple myeloma","volume":"4","author":"Munshi","year":"2020","journal-title":"Blood Adv."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e328","DOI":"10.1016\/S1470-2045(16)30206-6","article-title":"International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma","volume":"17","author":"Kumar","year":"2016","journal-title":"Lancet Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1182\/blood.2024024371","article-title":"EVIDENCE meta-analysis: Evaluating minimal residual disease as an intermediate clinical end point for multiple myeloma","volume":"144","author":"Landgren","year":"2024","journal-title":"Blood"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1182\/blood.2023022083","article-title":"Predictors of unsustained measurable residual disease negativity in transplant-eligible patients with multiple myeloma","volume":"143","author":"Guerrero","year":"2024","journal-title":"Blood"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1182\/blood.2020010439","article-title":"Sustained minimal residual disease negativity in newly diagnosed multiple myeloma and the impact of daratumumab in MAIA and ALCYONE","volume":"139","author":"Paiva","year":"2022","journal-title":"Blood"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1182\/blood.2022016782","article-title":"MRD dynamics during maintenance for improved prognostication of 1280 patients with myeloma in the TOURMALINE-MM3 and -MM4 trials","volume":"141","author":"Paiva","year":"2023","journal-title":"Blood"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"102284","DOI":"10.1016\/j.ctrv.2021.102284","article-title":"Roadmap to cure multiple myeloma","volume":"100","author":"Paiva","year":"2021","journal-title":"Cancer Treat. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2757","DOI":"10.1200\/JCO.23.00934","article-title":"Minimal Residual Disease Status in Multiple Myeloma 1 Year After Autologous Hematopoietic Cell Transplantation and Lenalidomide Maintenance Are Associated with Long-Term Overall Survival","volume":"42","author":"Pasquini","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"E341","DOI":"10.1002\/ajh.26255","article-title":"Persistent bone marrow minimal residual disease as a \u201chigh-risk\u201d disease feature in multiple myeloma","volume":"96","author":"Mohan","year":"2021","journal-title":"Am. J. Hematol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1182\/bloodadvances.2024014417","article-title":"MRD-driven phase 2 study of daratumumab, carfilzomib, lenalidomide, and dexamethasone in newly diagnosed multiple myeloma","volume":"9","author":"Bhutani","year":"2024","journal-title":"Blood Adv."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1182\/blood.2023020284","article-title":"Potential future direction of measurable residual disease evaluation in multiple myeloma","volume":"142","author":"Mohty","year":"2023","journal-title":"Blood"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1200\/JCO.19.01231","article-title":"Measurable Residual Disease by Next-Generation Flow Cytometry in Multiple Myeloma","volume":"38","author":"Paiva","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1182\/blood.2020006731","article-title":"Deep MRD profiling defines outcome and unveils different modes of treatment resistance in standard- and high-risk myeloma","volume":"137","author":"Goicoechea","year":"2021","journal-title":"Blood"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1007\/s00277-019-03609-x","article-title":"Achieving minimal residual disease-negative by multiparameter flow cytometry may ameliorate a poor prognosis in MM patients with high-risk cytogenetics: A retrospective single-center analysis","volume":"98","author":"Li","year":"2019","journal-title":"Ann. Hematol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"100252","DOI":"10.1016\/j.clinme.2024.100252","article-title":"Dynamics of minimal residual disease and its clinical implications in multiple myeloma: A retrospective real-life analysis","volume":"24","author":"Xu","year":"2024","journal-title":"Clin. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e221","DOI":"10.1016\/j.clml.2020.01.001","article-title":"Minimal Residual Disease Negativity Does Not Overcome Poor Prognosis in High-Risk Multiple Myeloma: A Single-Center Retrospective Study","volume":"20","author":"Kunacheewa","year":"2020","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1001\/jamaoncol.2016.3160","article-title":"Association of Minimal Residual Disease with Superior Survival Outcomes in Patients with Multiple Myeloma: A Meta-analysis","volume":"3","author":"Munshi","year":"2017","journal-title":"JAMA Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2456","DOI":"10.1182\/blood-2018-06-858613","article-title":"Minimal residual disease negativity using deep sequencing is a major prognostic factor in multiple myeloma","volume":"132","author":"Perrot","year":"2018","journal-title":"Blood"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e422","DOI":"10.1016\/S2352-3026(21)00130-7","article-title":"Dynamics of minimal residual disease in patients with multiple myeloma on continuous lenalidomide maintenance: A single-arm, single-centre, phase 2 trial","volume":"8","author":"Diamond","year":"2021","journal-title":"Lancet Haematol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e063037","DOI":"10.1136\/bmjopen-2022-063037","article-title":"Risk and response adapted therapy following autologous stem cell transplant in patients with newly diagnosed multiple myeloma (RADAR (UK-MRA Myeloma XV Trial): Study protocol for a phase II\/III randomised controlled trial","volume":"12","author":"Royle","year":"2022","journal-title":"BMJ Open"},{"key":"ref_28","first-page":"2049","article-title":"Role of minimal residual disease assessment in multiple myeloma","volume":"109","author":"Szalat","year":"2024","journal-title":"Haematologica"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2889","DOI":"10.1200\/JCO.21.02228","article-title":"Minimal Residual Disease After Autologous Stem-Cell Transplant for Patients with Myeloma: Prognostic Significance and the Impact of Lenalidomide Maintenance and Molecular Risk","volume":"40","author":"Pawlyn","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1158\/2767-9764.CRC-23-0185","article-title":"Clinical Benefit of Autologous Stem Cell Transplantation for Patients with Multiple Myeloma Achieving Undetectable Minimal Residual Disease after Induction Treatment","volume":"3","author":"Liu","year":"2023","journal-title":"Cancer Res. Commun."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2568","DOI":"10.1016\/j.bbmt.2018.07.040","article-title":"Longitudinal Flow Cytometry Identified \u201cMinimal Residual Disease\u201d (MRD) Evolution Patterns for Predicting the Prognosis of Patients with Transplant-Eligible Multiple Myeloma","volume":"24","author":"Gu","year":"2018","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S1470-2045(22)00693-3","article-title":"Carfilzomib induction, consolidation, and maintenance with or without autologous stem-cell transplantation in patients with newly diagnosed multiple myeloma: Pre-planned cytogenetic subgroup analysis of the randomised, phase 2 FORTE trial","volume":"24","author":"Mina","year":"2023","journal-title":"Lancet Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1007\/s12672-024-00891-8","article-title":"Real-world prognostic significance of attaining minimal residual disease negativity in newly diagnosed multiple myeloma","volume":"15","author":"Wang","year":"2024","journal-title":"Discov. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"E61","DOI":"10.1002\/ajh.26810","article-title":"Dynamic monitoring of minimal residual disease in newly-diagnosed multiple myeloma","volume":"98","author":"Yang","year":"2023","journal-title":"Am. J. Hematol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2353","DOI":"10.1182\/blood.2024027686","article-title":"Sustained bone marrow and imaging MRD negativity for 3 years drives discontinuation of maintenance post-ASCT in myeloma","volume":"145","author":"Terpos","year":"2025","journal-title":"Blood"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/10\/1569\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T04:31:10Z","timestamp":1778733070000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/10\/1569"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":35,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["cancers18101569"],"URL":"https:\/\/doi.org\/10.3390\/cancers18101569","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,12]]}}}