{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:39Z","timestamp":1789448559263,"version":"build-2803163510"},"reference-count":31,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T00:00:00Z","timestamp":1789257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82270209"],"award-info":[{"award-number":["82270209"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82470197"],"award-info":[{"award-number":["82470197"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"award":["82270209"],"award-info":[{"award-number":["82270209"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]},{"award":["82470197"],"award-info":[{"award-number":["82470197"]}],"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: Minimal residual disease (MRD) is an established prognostic factor in multiple myeloma (MM), but the significance of dynamic MRD changes before and after autologous stem cell transplantation (ASCT) remains unclear. Methods: We retrospectively analysed 335 newly diagnosed MM patients who underwent upfront ASCT. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan\u2013Meier method and compared using the log-rank test. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence interval (CI), adjusting for clinical risk factors. Results: Patients were classified as having persistent MRD negativity (n = 82, 24.5%), MRD\u2212 to MRD+ conversion (n = 40, 11.9%), MRD+ to MRD\u2212 conversion (n = 168, 50.1%), or persistent MRD positivity (n = 45, 13.4%). Median OS was not reached: 105, 131, and 87 months for the groups (p &lt; 0.001); and PFS was not reached: 50, 71, and 38 months (p &lt; 0.001). In multivariable analysis, persistent MRD positivity (HR, 4.762; 95% CI, 2.151\u201310.546; p &lt; 0.001) and MRD\u2212 to MRD+ conversion (HR, 3.925; 95% CI, 1.791\u20138.598; p &lt; 0.001) were associated with increased mortality risk compared with persistent MRD negativity, whereas MRD+ to MRD\u2212 conversion showed a borderline-significant increase (HR, 1.973; 95% CI, 0.963\u20134.046; p = 0.063). In addition, similar patterns were observed for PFS. In subgroup analyses, late MRD+ to MRD\u2212 conversion was associated with inferior PFS (HR, 1.857; 95% CI, 1.136\u20133.034; p = 0.014), whereas MRD\u2212 to MRD+ conversion showed no differences in OS or PFS (all p &gt; 0.05). Among persistent MRD-positive patients, stable or increasing MRD pattern predicted worse outcomes (HR, 4.397; 95% CI, 1.190\u201316.240; p = 0.026). Conclusions: Longitudinal MRD trajectories provided independent prognostic information beyond static MRD assessment in MM. Subgroup analyses further suggest that dynamic MRD assessment might help refine risk stratification after ASCT.<\/jats:p>","DOI":"10.3390\/cancers18182958","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T09:34:01Z","timestamp":1789378441000},"page":"2958","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Prognostic Significance of Dynamic Monitoring of Minimal Residual Disease Status in Patients with Multiple Myeloma: A Real-World Study"],"prefix":"10.3390","volume":"18","author":[{"given":"Xiaotong","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Haematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaozhe","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Haematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6462-3547","authenticated-orcid":false,"given":"Junru","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Haematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beihui","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Haematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingli","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Haematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, 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 Haematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifen","family":"Kuang","sequence":"additional","affiliation":[{"name":"Department of Haematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, 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 Haematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1038\/s41571-025-01041-x","article-title":"EHA\u2013EMN Evidence-Based Guidelines for diagnosis, treatment and follow-up of patients with multiple myeloma","volume":"22","author":"Dimopoulos","year":"2025","journal-title":"Nat. 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