Vol 8, No 4 (2017)
Review paper
Published online: 2018-02-24
Current role of minimal residual disease in plasma cell myeloma: Position of Polish Myeloma Consortium
Hematologia 2017;8(4):246-254.
Abstract
< strong > < /strong > Wprowadzenie do terapii szpiczaka plazmocytowego (PCM) znacznej liczby nowych leków pozwoliło na poprawę głębokości uzyskiwanych odpowiedzi, a w konsekwencji na wydłużenie okresu remisji i przeżycia chorych. Mimo wyższego obecnie odsetka całkowitych remisji (CR) u większości pacjentów dochodzi jednak do nawrotu choroby, co może być tłumaczone pozostawaniem po zakończeniu leczenia niewielkich populacji klonalnych plazmocytów w szpiku kostnym, określanych mianem minimalnej choroby resztkowej (MRD). Prognostyczne znaczenie występowania MRD u chorych w CR potwierdzono w wielu badaniach klinicznych, a ocena MRD stała się w ostatnim czasie rutynowym narzędziem w ocenie skuteczności najnowszych leków i schematów terapii. Ponadto w najnowszych kryteriach odpowiedzi IMWG (International Myeloma Working Group) z 2016 roku wprowadzono kategorie odpowiedzi oparte na badaniu MRD oznaczanej z czułością co najmniej 10–5 najnowocześniejszymi technikami diagnostycznymi — cytometrii przepływowej nowej generacji i sekwencjonowania nowej generacji. W pracy podsumowano aktualne znaczenie oceny MRD u chorych na PCM, ze szczególnym uwzględnieniem metodyki oceny MRD techniką cytometrii przepływowej. W opinii Polskiego Konsorcjum Szpiczakowego upowszechnienie i standaryzacja oceny MRD w PCM może się przyczynić do poprawy wyników leczenia chorych na ten nowotwór w Polsce.
Keywords: plasma cell myelomaminimal residual diseaseprognosis
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