Citations 1
Predictors of posttransplant measurable residual disease negativity and impact on clinical outcomes in multiple myeloma
Bolarinwa, Abiola , Zanwar, Saurabh , Abdallah, Nadine , Nagaraj, Madhu , Seth, Sukriti, Buadi, Francis K. , Hayman, Suzanne R. , Gertz, Morie A. , Muchtar, Eli , Kapoor, Prashant , Gonsalves, Wilson I, Kourelis, Taxiarchis , Dingli, David, Warsame, Rahma , Lin, Yi, Hwa, Y., Rogers, Michelle Genevieve, Hobbs, Miriam A, Fonder, Amie , Jevremovic, Dragan, Rajkumar, S Vincent, Kumar, Shaji , Zanwar, Saurabh S , Dispenzieri, Angela , Muchtar, E , Kourelis, Taxiarchis , Warsame, Rahma , Leung, Nelson , Cook, Joselle M , Binder, Moritz , Hwa, Yi Lisa, Fonder, Amie , Kumar, Shaji K , Gertz, Morie A , Buadi, Francis K , Bolarinwa, Abiola B , Dispenzieri, Angela , Gonsalves, Wilson I. , Dingli, David , Leung, Nelson , Cook, Joselle , Binder, Moritz , Hobbs, Miriam, Jevremović, Dragan , Rajkumar, S. Vincent
Blood Advances | July 28, 2026 | Volume: 10 | Issue: 19 | Pages: 6694-6702
10.1182/bloodadvances.2026020294
Abstract Measurable residual disease (MRD) is a powerful prognostic tool in multiple myeloma, but predictors of achieving MRD negativity after autologous stem cell transplantation (ASCT) are not well defined. We studied 814 patients who achieved at least a very good partial response after ASCT between January 2016 and January 2023 and underwent MRD assessment by next-generation flow cytometry. Overall, 387 (48%) achieved MRD negativity after ASCT. The presence of t(11;14) (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.4–3.2; P< .01) and pretransplant response less than complete remission (OR, 2.1; 95% CI, 1.2-3.7; P< .01) independently predicted MRD positivity. Patients who were MRD positive had inferior progression-free survival (PFS; hazard ratio [HR], 1.99; 95% CI, 1.53-2.58; P< .001) and overall survival (HR, 1.62; 95% CI, 1.10-2.28; P = .009). Despite lower MRD-negative rate, 5-year PFS was similar among t(11;14) MRD positive (58%) and patients who were MRD negative (63%; P = .12). In patients who were MRD negative, the 5-year PFS was 73% in those without ≥2 HRCA compared with 55% in those with ≥2 HRCA (HR 1.9, 95% CI 1.2–3.3; P = .01). In the MRD-positive cohort, 5-year PFS was 53% in patients without ≥2 HRCA vs 17% in those with ≥2 HRCA (HR, 2.4; 95% CI, 1.6-3.6; P< .01). In addition, higher residual clonal plasma cell burden within MRD-positive disease was associated with inferior PFS (HR, 2.4; 95% CI, 1.2-6.9; P = .002). This study highlights that the presence of t(11;14) independently predicts MRD positivity after ASCT, although it does not significantly affect prognosis in this subgroup.