Figure 1.
PRISMA flowchart of the systematic literature review search strategy and article selection. The literature review was conducted in adherence to PRISMA guidelines. Medline and EMBASE databases were searched for articles published in English up to 8 June 2019; there was no date limit on the indexed database searches. Details of the search strategy were performed as follows: medical subject heading (MeSH) terms for MM were “MM” and “neoplasm, residual.” Non-MeSH search terms were “Kahler disease” (or “Kahler’s disease” or “myelomatosis” or “plasma cell myeloma”) and/or “MRD.” Selected congress abstracts published between 2016 and 2019, including additional literature, were manually reviewed. Bibliographies of systematic literature review articles on MM published between 2014 and 2019 were reviewed manually to identify additional potentially relevant publications. Additional sources were used for validation, including studies identified in public assessment reports published by the European Medicines Agency and the FDA. PICOS (Population, interventions, comparisons, outcomes, and study design) criteria were used to define eligibility. Patients could have received any type of therapy except allogeneic stem cell transplantation. Studies with PFS or OS data that could not be extracted or reconstructed were excluded. Studies with patients who did not have a primary diagnosis of MM were also excluded, as were those with MRD measured only in peripheral blood or assessed only by positron emission tomography–computed tomography scanning. Two independent investigators selected the articles for potential inclusion. RCTs and observational studies that reported PFS or OS rates stratified by MRD status in patients with MM following therapy were eligible for inclusion (supplemental Table 1). The methodological quality of the studies was assessed using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) reporting recommendations. A manual search was conducted to identify any updated publications on selected studies. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

PRISMA flowchart of the systematic literature review search strategy and article selection. The literature review was conducted in adherence to PRISMA guidelines. Medline and EMBASE databases were searched for articles published in English up to 8 June 2019; there was no date limit on the indexed database searches. Details of the search strategy were performed as follows: medical subject heading (MeSH) terms for MM were “MM” and “neoplasm, residual.” Non-MeSH search terms were “Kahler disease” (or “Kahler’s disease” or “myelomatosis” or “plasma cell myeloma”) and/or “MRD.” Selected congress abstracts published between 2016 and 2019, including additional literature, were manually reviewed. Bibliographies of systematic literature review articles on MM published between 2014 and 2019 were reviewed manually to identify additional potentially relevant publications. Additional sources were used for validation, including studies identified in public assessment reports published by the European Medicines Agency and the FDA. PICOS (Population, interventions, comparisons, outcomes, and study design) criteria were used to define eligibility. Patients could have received any type of therapy except allogeneic stem cell transplantation. Studies with PFS or OS data that could not be extracted or reconstructed were excluded. Studies with patients who did not have a primary diagnosis of MM were also excluded, as were those with MRD measured only in peripheral blood or assessed only by positron emission tomography–computed tomography scanning. Two independent investigators selected the articles for potential inclusion. RCTs and observational studies that reported PFS or OS rates stratified by MRD status in patients with MM following therapy were eligible for inclusion (supplemental Table 1). The methodological quality of the studies was assessed using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) reporting recommendations. A manual search was conducted to identify any updated publications on selected studies. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

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