Citations 1
Cytogenetics-based Clinical Trajectories in Patients with MRD Negativity Post Autologous Transplant for Multiple Myeloma
Zanwar, Saurabh , Mariotti, E, Kumar, Shaji, Gonsalves, W., Buadi, Francis K. , HAYMAN, Suzanne, Abdallah, N., Binder, Moritz , Cook, Joselle, Dispenzieri, Angela, Dingli, D., Gertz, M., Kourelis, Taxiarchis, Leung, Nelson, Lin, Yi, Siddiqui, Mustaqueem, Go, R., Muchtar, E., Warsame, Rahma, Jevremovic, Dragan, Kyle, RA, Kapoor, Prashant , Rajkumar, S. Vincent, Gonsalves, Wilson I. , Cook, Joselle , Gauto‐Mariotti, Estefania , Gonsalves, Wilson , Binder, Moritz , Buadi, Francis K , Cook, Joselle M , Mariotti, Estefania Gauto , Kumar, Shaji , Hayman, Suzanne R. , Abdallah, Nadine , Dispenzieri, Angela , Dingli, David , Gertz, Morie A. , Kourelis, Taxiarchis , Leung, Nelson , Lin, Yi , Siddiqui, Mustaqeem , Go, Ronald S. , Muchtar, Eli , Warsame, Rahma , Jevremović, Dragan , Kyle, R A, Rajkumar, S. Vincent
No container title available | January 20, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Measurable residual disease (MRD) assessment has become central to risk-adapted treatment strategies in multiple myeloma, yet the prognostic value of MRD negativity following autologous stem cell transplantation (ASCT) across individual high-risk cytogenetic abnormalities (HRCAs) remains unclear. We analyzed 351 newly diagnosed patients who achieved MRD negativity (sensitivity 2.4×10 − 6 ) at Day 100 following ASCT and had baseline cytogenetic data available. Median follow-up was 50.4 months. Standard-risk cytogenetics were present in 46% (n = 162), while 34% (n = 118) had one HRCA and 20% (n = 71) had ≥ 2 HRCAs. Despite uniform MRD negativity, several HRCAs continued to confer inferior progression-free survival (PFS). Compared with the standard-risk group (4-year PFS 84%), patients with del(17p), 1q21+, t(4;14), or MAF translocations [t(14;16)/t(14;20)] had significantly lower 4-year PFS rates: 56% (HR 2.89; p = 0.0001), 60% (HR 2.46; p = 0.0001), 43% (HR 3.50; p = 0.0001), and 58% (HR 2.51; p = 0.01), respectively. Isolated del(17p) and 1q21 + also conferred inferior PFS. The 4-year PFS was 65% for patients with one HRCA (HR 2.31; p = 0.0004) and 55% for those with ≥ 2 HRCAs (HR 2.75; p = 0.0001). In this large MRD-negative post-ASCT cohort, several HRCAs, including isolated HRCAs, remained clinically meaningful drivers of inferior PFS, highlighting that early MRD negativity does not uniformly mitigate the impact of high-risk biology.