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Minimal residual disease negativity in multiple myeloma is associated with intestinal microbiota composition.

ABSTRACT: Patients with multiple myeloma (MM) who achieve minimal residual disease (MRD) negativity after upfront treatment have superior outcomes compared with those who remain MRD⁺ Recently, associations have been shown between specific commensal microbes and development of plasma cell disorders. Here, we report the association between intestinal microbiota composition and treatment outcome in MM. Microbiota composition of fecal samples collected from 34 MM patients after induction therapy and at the time of flow cytometry-based bone marrow MRD testing was determined by 16S ribosomal RNA sequencing. We observed a higher relative abundance of Eubacterium hallii in the 16 MRD^- patients relative to the 18 MRD⁺ patients. No association was observed between microbial relative abundance and autologous stem cell transplantation history or MM paraprotein isotype. No differences in microbiota ? diversity were observed between MRD^- and MRD⁺ patients. The potential association of microbiota composition with treatment response in MM patients is an important parameter for additional correlative and clinical investigation.

SUBMITTER: Pianko MJ

PROVIDER: S-EPMC6616258 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Minimal residual disease negativity in multiple myeloma is associated with intestinal microbiota composition.

Pianko Matthew J MJ Devlin Sean M SM Littmann Eric R ER Chansakul Aisara A Mastey Donna D Salcedo Meghan M Fontana Emily E Ling Lilan L Tavitian Elizabet E Slingerland John B JB Slingerland Ann E AE Clurman Annelie A Gomes Antonio L C ALC Taur Ying Y Pamer Eric G EG Peled Jonathan U JU van den Brink Marcel R M MRM Landgren Ola O Lesokhin Alexander M AM

Blood advances 20190701 13

Patients with multiple myeloma (MM) who achieve minimal residual disease (MRD) negativity after upfront treatment have superior outcomes compared with those who remain MRD<sup>+</sup> Recently, associations have been shown between specific commensal microbes and development of plasma cell disorders. Here, we report the association between intestinal microbiota composition and treatment outcome in MM. Microbiota composition of fecal samples collected from 34 MM patients after induction therapy an ...[more]

PMID: 31289031

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Project description:BackgroundMinimal residual disease (MRD) is a standard measurement for response assessment in multiple myeloma (MM). Despite new treatments, high-risk MM patients continue to have poor prognosis. We evaluated the effect of MRD negativity in high-risk versus standard-risk patients.Patients and methodsWe retrospectively evaluated all consecutive MM patients who underwent routine MRD testing by 1-tube 8-color advanced flow cytometry with 2,000,000 events and sensitivity level 10-5 at our center from 2015 to 2018 after initial therapy. Kaplan-Meier and log-rank test were used to assess survival estimates and differences between study groups.ResultsOne hundred thirty-six patients with MRD testing after initial therapy or autologous stem-cell transplantation were identified. At a median follow-up of 14 months (range, 1-36 months), progression-free survival and overall survival were significantly worse in high-risk versus standard-risk patients. During the study period, 50% of high-risk group had experienced disease progression (relapse and/or death) versus 20% in the standard-risk group (P = .0006). No patients with standard-risk died, but 4 (14%) in the high-risk group did (P = .0007). Regardless of MRD status, high-risk patients had statistically significant worse progression-free survival than standard-risk patients. At median follow-up, those with disease 10% standard-risk/MRD negative; 20% standard-risk/MRD positive; 40% high-risk/MRD negative; and 45% high-risk/MRD positive had either experienced relapse or died (P = .0041). MRD status did not significantly affect overall survival in either group (P = .0914); however, longer follow-up is needed to assess survival.ConclusionGenetic abnormalities remain a powerful prognostic indicator for MM, regardless of MRD status. For newly diagnosed MM patients treated with novel triple-drug initial therapy and frontline autologous stem-cell transplantation, MRD-negative status did not mitigate the poor-prognosis outcomes of high-risk MM patients.

Dataset Information

Minimal residual disease negativity in multiple myeloma is associated with intestinal microbiota composition.

Publications

Minimal residual disease negativity in multiple myeloma is associated with intestinal microbiota composition.

Similar Datasets

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