Minimal residual disease (MRD) refers to the small number of myeloma cells below the limit of detection available with conventional morphologic assessment.40 These residual myeloma cells are clinically relevant, as they may lead to disease progression and relapse.16, 41
The response criteria have evolved over time due to therapeutic advances in multiple myeloma. In 1998, a conventional complete response (CR) required bone marrow aspirates with less than 5% plasma cells, irrespective of their clonal nature. Current technology allows for further identification of myeloma cells by cell-surface markers expression and genomic architecture.41
ASO-PCR, allele-specific oligonucleotide polymerase chain reaction; BM, bone marrow; FC, flow cytometry; IF, immunofluorescence; IHC, immunohistochemistry; MM, multiple myeloma; NGF, next-generation flow; NGS, next-generation sequencing; PC, plasma cells
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