长期的临床实践结果表明,获得传统意义完全缓解的多发性骨髓瘤(MM)患者预后有很大差异,有的患者在2年内很快复发,甚至死亡,而有的患者可获得长期生存.因此,对微小残留病(MRD)的评估应运而生,实现了对个体治疗的严密监控和对预后更加精确的判断.MRD可用基于免疫表型的多参数流式细胞术、等位基因特异性寡核苷酸杂交法聚合酶链反应、二代测序技术实现对骨髓内部情况的监控,也可用敏感的影像学技术对骨髓外部情况进行监控.文章就MM中MRD检测的临床意义、不同MRD检测方法的优缺点及未来发展方向进行系统的阐述.%Long time clinical results have showed that multiple myeloma (MM) patients who achieved complete remission (CR) had heterogeneous prognosis. Some patients who achieved CR relapsed in a short time, even died within 2 years after initial therapy, while other patients acquired long-term survival. With the emergence of minimal residual disease (MRD) assessment, rigorous personal therapy monitoring and accurate prognostic evaluation could be realized. MRD can monitor inside the bone marrow by multi-parameter flow cytometry, allele-specific oligonucleotide-based quantitative polymerase chain reaction and next-generation sequencing, as well as the external conditions of the bone marrow by sensitive imaging techniques. This article focuses on clinical benefit, characteristics of different monitoring methods and future direction of MRD in MM.
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