多発性骨髄腫の予後予測解析ツールとしてのマルチカラー・フローサイトメトリー

抄録

Multiple myeloma is an incurable malignant disease of clonal plasma cells which infiltrate in the bone marrow. The introduction of several novel drugs including immunomodulatory drugs and proteasome inhibitors, and high-dose therapy followed by autologous stem cell transplantation has doubled overall survival times. During the last decade, considerable progress has been also made in understanding the biology of myeloma and molecular heterogeneity which influences the prognoses. Along with previously described prognostic factors, gene expression profiling allows the assessment of prospective risk stratification of myeloma patients. To choose the optimal treatment for each patient, risk-adapted strategies using well-defined prognostic factors are urgently needed. Many clinical studies about the efficacy of novel therapies showed the achievement of complete response (CR) is associated with prolonged progression-free survival. However, the long-term outcome of myeloma patients after therapy is still heterogenous. Some patients lose CR within three years while a small fraction of patients (5-15 %) remain recurrence-free for over 10 years. Thus, more sensitive techniques for assessment of response and tumor burden after treatment would be helpful. In this article, we review the utility of multiparametric flow cytometry for evaluation of prognostic markers and of monitoring minimal residual disease in multiple myeloma.