This article reviews the role of minimal residual disease (MRD) testing in multiple myeloma (MM), highlighting its association with improved progression-free survival and overall survival. MRD-negative status correlates with better long-term outcomes, and advances in next-generation sequencing and flow cytometry have enhanced MRD detection. While MRD testing provides important prognostic information, its role in guiding treatment decisions outside of clinical trials is still under investigation, and more research is needed to establish its clinical utility.

The authors also discuss a clinical case of a patient with monoclonal gammopathy of undetermined significance (MGUS) who remained MRD-negative for two years after autologous stem cell transplant but tested positive for low-level MRD at the five-year mark. Despite the MRD positivity, the patient chose to continue her current therapy. This case underscores the challenges of interpreting MRD results. It also highlights the need for further studies to determine how MRD testing, along with functional imaging and liquid biopsies, can be effectively integrated into clinical decision-making.

Reference: Yee AJ, Raje N. Minimal Residual Disease in Multiple Myeloma: Why, When, Where. Hematology Am Soc Hematol Educ Program. 2021;2021(1):37-45. doi: 10.1182/hematology.2021000230.