The survey also found wide variance in the number of FC parameters/colors used, and just 5 laboratories reported using molecular methods based on the next generation sequencing recommended by the International Myeloma Working Group.

“This study shows that in the real world, in the United States, people don’t do this right,” Dr Landgren said. “There are only 6 institutions in the United States, according to this, that have good testing for myeloma in the clinical setting.”

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The survey comes just as FDA interest and independent studies that associate MRD negativity with longer progression-free and overall survival are coming together, and on the heels of a newly released International Myeloma Working Group (IMWG) guideline, which establishes uniform response criteria for measuring the effect of treatment.2

Published in The Lancet Oncology in August, the IMWG consensus found that with “an assay that delivers negativity of 1 cell in 100,000 or 10-5, and the patient is in complete response,” Dr Landgren said, “you can declare MRD negativity.”

A meta-analysis Dr Landgren conducted is due out within the month, he said, which will add detail to his findings of a powerful correlation between MRD negativity and longer progression-free and overall survival.

“A standard is certainly required,” he said. “I think we need better technology that is easier to implement without dedicated personnel and complicated procedures.”

Disclosures: the author has no relationships to report.


  1. Salem D, Stetler-Stevenson M, Yuan C, Landgren O. Myeloma minimal residual disease testing in the United States: Evidence of improved standardization. Am J Hematol. 2016 Aug 24. doi: 10.1002/ajh.24540 [Epub ahead of print]
  2. Kumar S, Paiva B, Anderson KC, et. al. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol. 2016;17(8):e328-46. doi: 10.1016/S1470-2045(16)30206-6