Study Reveals Variations In Minimal Residual Disease Testing For Myeloma – Results from a recent study suggest that testing for residual multiple myeloma after treatment varies widely across medical institutions in the United States. Among 26 institutions surveyed, 42 percent offered testing services for minimal residual disease (MRD). In addition, the tests conducted by some institutions were 100-fold more sensitive than others at detecting residual cells. The parameters used to identify myeloma cells and the number of myeloma cells needed to classify a sample as MRD-positive also varied across institutions. According to the investigators, these findings highlight the need for collaborative efforts to develop standardized criteria for MRD testing. They added that future studies are also required to identify the best time to test for residual disease. Myeloma cells that remain in the bone marrow after treatment contribute to residual disease. Detecting residual disease is thought to be important since previous studies have linked residual disease to shorter survival. MRD testing is performed on bone marrow cells, typically using a technique called flow cytometry. Most of the institutions in this study tested for MRD upon achievement of a complete response. For more information, please see the study in the journal Blood ^[1] (subscription required).

Blood Levels Of BAFF Protein Linked To Myeloma Disease Activity – Findings from a recent Greek study suggest that blood levels of the protein BAFF can be used as a marker of disease activity in multiple myeloma patients. B cell activating factor (BAFF) plays a critical role in the proliferation of plasma cells. Comparing blood samples from 54 newly diagnosed myeloma patients and 24 healthy individuals, the researchers found that BAFF levels were significantly increased in myeloma patients. Patients with advanced myeloma showed higher BAFF levels than patients with early stage disease. The researchers also measured the concentrations of a number of proteins involved in plasma cell proliferation (including interleukin-6 and interleukin-10) and found that BAFF levels closely paralleled the levels of these proteins. The investigators further measured BAFF concentrations in a subset of patients after they achieved a complete response or very good partial response with chemotherapy. These results showed that BAFF levels were significantly decreased after effective treatment. Based on these findings, the researchers suggest that levels of BAFF in the blood can be used as a marker for myeloma cell proliferation and disease activity. For more information, please see the study in BioMed Research International ^[2].

Presence Of Protein CD20 May Predict Disease Outcome In Myeloma Patients With Chromosomal Abnormality t(11;14) – Chinese researchers have recently found that myeloma patients with the chromosomal abnormality t(11;14) may show normal or poor disease outcome depending upon the presence of a protein called CD20. After Velcade ^[3] (bortezomib)-based treatment, patients whose myeloma cells contained both t(11;14) and the CD20 protein showed significantly longer progression-free survival than patients who had t(11;14) without CD20 (43 months versus 11 months). Overall survival was also longer in patients whose myeloma cells had CD20 as compared to patients without CD20 (54 months versus 17 months). Although t(11;14) is the most common chromosomal abnormality seen in myeloma cells, its impact on treatment outcome has remained controversial (see related Beacon news ^[4]). In general, patients with t(11;14) are not classified as having high-risk disease. As a caveat, findings from this China-based study may not be directly applicable to myeloma patients of other ethnicities and will therefore require further validation. For more information, please see the study in Leukemia Research ^[5] (abstract).