Reference Values to Assess Hemodilution and Warn of Potential False-Negative Minimal Residual Disease Results in Myeloma

Cancers

Irene Manrique¹  Jesús F. San Miguel¹  Leire Burgos¹  Paula Rodríguez-Otero¹  Bruno Paiva¹  Lourdes Cordón²  José-Juan Pérez³  María-Victoria Mateos³  Noemí Puig³  Joan Bladé⁴  Laura Rosiñol⁴  Juan-José Lahuerta⁵  María-Teresa Cedena⁵  Joaquín Martínez-López⁵  Juan Flores-Montero⁶  Alberto Orfao⁶  Luzalba Sanoja-Flores⁷ 

[1] Clínica Universidad de Navarra, Centro de Investigación Aplicada (CIMA), Instituto de Investigación Sanitaria de Navarra (IDISNA), CIBERONC (CB16/12/00369), 31008 Pamplona, Spain;Grupo de Investigación en Hematología, Instituto de Investigación Sanitaria La Fe (IIS La Fe), CIBERONC (CB16/12/00284), 46026 Valencia, Spain;Hematology Department, Hospital Universitario de Salamanca (HUSAL), IBSAL, IBMCC (USAL-CSIC), CIBERONC (CB16/12/00233), 37007 Salamanca, Spain;Hematology Department, IDIBAPS, Hospital Clinic, 08036 Barcelona, Spain;Hospital Universitario 12 de Octubre, CIBERONC (CB16/12/00369), 28041 Madrid, Spain;Institute of Biomedical Research of Salamanca (IBSAL), Centro de Investigación Biomédica en Red Cáncer CIBERONC (CB16/12/00400), Cancer Research Center (IBMCC, USAL-CSIC), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, 37007 Salamanca, Spain;Institute of Biomedicine of Seville, Department of Hematology, University Hospital Virgen del Rocío of the Consejo Superior de Investigaciones Científicas (CSIC), University of Seville, Seville, Spain & CIBERONC (CB16/12/00480), Instituto Carlos III, 28029 Madrid, Spain;

关键词: multiple myeloma;    minimal residual disease;    hemodilution;   

DOI  :  10.3390/cancers13194924

来源: DOAJ

【 摘 要 】

Background: Whereas, in most patients with multiple myeloma (MM), achieving undetectable MRD anticipates a favorable outcome, some others relapse shortly afterwards. Although one obvious explanation for this inconsistency is the use of nonrepresentative marrow samples due to hemodilution, there is no guidance on how to evaluate this issue. Methods: Since B-cell precursors, mast cells and nucleated red blood cells are normally absent in peripheral blood, we analyzed them in 1404 bone marrow (BM) aspirates obtained in numerous disease settings and in 85 healthy adults (HA). Results: First, we confirmed the systematic detection of the three populations in HA, as well as the nonreduced numbers with aging. Pairwise comparisons between HA and MM patients grouped according to age and treatment showed significant variability, suggesting that hemodilution should be preferably evaluated with references obtained from patients treated with identical regimens. Leveraging the MRD results from 118 patients, we showed that a comparison with HA of similar age could also inform on potential hemodilution. Conclusions: Our study supports the routine assessment of BM cellularity to evaluate hemodilution, since reduced BM-specific cell types as compared to reference values (either treatment-specific or from HA if the former are unavailable) could indicate hemodilution and a false-negative MRD result.

【 授权许可】

Unknown