![]() Every CMMC positive case was also BM MRD positive. However, 42% of the samples that were CMMC positive were negative on immunofixation. Forty percent of patients who were BM MRD positive were CMMC negative in the paired PB sample, and 30% of patients that were IFE positive were CMMC negative in the paired PB sample. Following therapy, CMMCs were detected in the PB of 26% of MM cases. A total of 274 paired BM and PB samples were analysed, in addition to 54 follow-up PB samples. This follow-up study involved 137 newly diagnosed MM patients post-treatment. This group further investigated the clinical utility of using NGF to detect CMMCs in PB by comparing its application to analysing BM samples with NGF and serum samples with IFE. However, it is important to acknowledge that as this study did not compare these methods using the same sample populations, the claim is somewhat speculative. ![]() The authors claimed that because of the high sensitivity of PCR, 43% more BM MRD positives and 12% more PB MRD positives were identified, compared to studies using methods such as multiparameter flow cytometry (MFC) or NGS. Interestingly, the authors also reported that as long as the PB was MRD positive, the BM was also MRD positive, supporting the potential of using PB based methods to reduce the number of BM samples required. In 67% of paired samples, BM was MRD positive, but PB was MRD negative, highlighting the significant difference in MRD analysis sensitivity in PB versus BM. The results demonstrated that CMMCs reduced significantly with every cycle of therapy, and reduction positively correlated with the patients' clinical response. To determine if CMMCs could be used as a biomarker for response therapy beyond MRD diagnostics, the authors of this study used ASO-PCR and stated a high-level sensitivity of below 10 −6. Graphical AbstractĪ more recent 2017 study comparing CMMCS and malignant PCs in the BM involved samples collected from a multicentre phase 3 clinical trial for newly diagnosed MM. This review will describe the current blood-based techniques available to detect MRD in MM and compare their potential to evaluate patient prognosis and drive therapeutic decisions. By simplifying serial sampling and allowing for the detection of extramedullary disease, a blood-based method could significantly impact treatment duration and intensity and minimise chemotherapy-induced toxicity. In clinical laboratories, these methods currently require bone marrow aspirates which are invasive and frequently miss detection of localised disease due to the spatial heterogeneity of disease infiltration. Methods to improve MRD detection in MM patients are generating considerable interest as a means of monitoring patients' response to treatment. Most MM patients will eventually relapse due to residual drug-resistant cancerous cells that survive treatment, commonly referred to as minimal residual disease (MRD). ![]() In recent years, the life expectancy of Multiple Myeloma (MM) patients has substantially improved, but this cancer remains incurable with increasing incidence in the developed world.
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