This is the fourth and final article in a series covering investigative tools used for diagnosing multiple myeloma.

Previous articles covered the diagnostic work-up for detecting multiple myeloma, which traditionally includes: (1) confirmation of the excessive growth of certain plasma cells ^[1]; (2) evaluation of organ damage ^[2]; and (3) determination of possible factors that may affect therapy and long-term outcome ^[3]. This article will discuss why select patients may be able to participate in specialized studies.

Several recent studies have investigated the production of protein from genes and important molecular pathways that lead to multiple myeloma. These studies have helped researchers understand the nature of myeloma. In particular, they have been useful for gene discovery and the identification of biomarkers, which are substances that indicate whether normal biological processes are taking place.

Because new drugs are more effective than previous treatments, many of the previous signs to predict prognosis are no longer relevant, and researchers need to find different signs to predict prognosis. Researchers have also found that some adverse factors no longer accurately foretell survival.

However, initial efforts to find new signs to predict prognosis require further and extensive validation. Myeloma patients with specific genetic or molecular characteristics may be able to take part in specialized studies designed for patients with those characteristics.

With more study, researchers hope to discover new gene-based signs to predict prognosis in myeloma. In this way, physicians will eventually be able to offer patients optimal individualized therapy, allowing physicians to select treatments that are most likely to be effective in a patient with specific genes and least likely to cause unnecessary side effects.

For more information about diagnostic criteria for multiple myeloma, see the full article in the American Society of Hematology’s 2008 Education Program Book, Hematology ^[4].