The Black Swan Research Initiative® (BSRI) is the International Myeloma Foundation's signature research program aimed at developing a definitive cure for myeloma. Led by a team of global myeloma experts, the BSRI provides coordination and support for more than 40 research projects around the world. Launched in 2012, BSRI research is already resulting in tangible benefits for myeloma patients. Learn about the latest BSRI manuscripts, abstracts, and presentations.


  1. Rodríguez-García A, Linares M, Luz Morales M, et al. Efficacy of Antiviral Treatment in Hepatitis C Virus (HCV)-Driven Monoclonal Gammopathies Including Myeloma. Front. Immunol., 11 January 2022 |
  2. Jiménez Ubieto A, Paiva B, Puig N, et al. Validation of the International Myeloma Working Group standard response criteria in the PETHEMA/GEM2012MENOS65 study: are these times of change? Blood. 2021 Nov 11;138(19):1901-1905. doi: 10.1182/blood.2021012319.
  3. Alameda D, Goicoechea I, Vacri M, et al. Tumor cells in light-chain amyloidosis and myeloma show distinct transcriptional rewiring of normal plasma cell development. Blood. 2021 Oct 28;138(17):1583-1589. doi: 10.1182/blood.2020009754.
  4. Puig N, Flores-Montero J, Burgos L, et al. Reference Values to Assess Hemodilution and Warn of Potential False-Negative Minimal Residual Disease Results in Myeloma. Cancers (Basel). 2021 Sep 30;13(19):4924. doi: 10.3390/cancers13194924.
  5. Rögnvaldsson S, Love TJ, Thorsteinsdottir S, et al. Iceland screens, treats, or prevents multiple myeloma (iStopMM): a population-based screening study for monoclonal gammopathy of undetermined significance and randomized controlled trial of follow-up strategies. Blood Cancer J. 2021 May 17;11(5):94.doi: 10.1038/s41408-021-00480-w
  6. Carrasco-Leon A, Ezponda T, Meydan C, et al. Characterization of complete lncRNAs transcriptome reveals the functional and clinical impact of lncRNAs in multiple myeloma. Leukemia. 2021 May;35(5):1438-1450. doi: 10.1038/s41375-021-01147-y. Epub 2021 Feb 17.
  7. Mendonca de Pontes R, Flores-Montero J, Sanoja-Flores L, et al. B-Cell Regeneration Profile and Minimal Residual Disease Status in Bone Marrow of Treated Multiple Myeloma Patients. Cancers (Basel). 2021 Apr 3;13(7):1704. doi: 10.3390/cancers13071704
  8. Damasceno D, Almeida J, Teodosio C, et al. Monocyte Subsets and Serum Inflammatory and Bone-Associated Markers in Monoclonal Gammopathy of Undetermined Significance and Multiple Myeloma. Cancers (Basel). 2021 Mar 22;13(6):1454. doi: 10.3390/cancers13061454
  9. Palladini G, Paiva B, Wechalekar A, et al. Minimal residual disease negativity by next-generation flow cytometry is associated with improved organ response in AL amyloidosis. Blood Cancer J. 2021 Feb 16;11(2):34. doi: 10.1038/s41408-021-00428-0.
  10. Catalano C, Paramasivam N, Blocka J, et al. Characterization of rare germline variants in familial multiple myeloma. Blood Cancer J. 2021 Feb 13;11(2):33.
    doi: 10.1038/s41408-021-00422-6
  11. Goicoechea I, Puig N, Cedena MT, et al. Blood Cancer J. 2021 Feb 16;11(2):34. doi: 10.1038/s41408-021-00428-0. Blood (2021) 137 (1): 49–60.
  12. Cuenca I, Alameda D, Sanchez-Vega B, et al. Immunogenetic characterization of clonal plasma cells in systemic light-chain amyloidosis. Leukemia. 2021 Jan;35(1):245-249. doi: 10.1038/s41375-020-0800-6. Epub 2020 Mar 19.
  13. Garces JJ, Bretones G, Burgos L, et al. Circulating tumor cells for comprehensive and multiregional non-invasive genetic characterization of multiple myeloma. Leukemia. 2020 Nov; 34(11):3007-3018. doi: 10.1038/s41375-020-0883-0. Epub 2020 Jun 1.
  14. Perez C, Botta C, et al. Immunogenomic identification and characterization of granulocytic myeloid-derived suppressor cells in multiple myeloma. Blood. 2020 Jul 9;136(2):199-209. doi: 10.1182/blood.2019004537.
  15. Burgos L, Puig N, Cedena MT, et al. Measurable residual disease in multiple myeloma: ready for clinical practice? J Hematol Oncol. 2020 Jun 22;13(1):82. doi: 10.1186/s13045-020-00911-4.
  16. Maia C, Puig N, Cedena MT, et al. Biological and clinical significance of dysplastic hematopoiesis in patients with newly diagnosed multiple myeloma. Blood (2020 June) 135 (26): 2375–2387.
  17. Sanoja-Flores L, Flores-Montero J, et al. Detection of Circulating Tumor Plasma Cells in Monoclonal Gammopathies: Methods, Pathogenic Role, and Clinical Implications. Cancers (Basel). 2020 Jun 8;12(6):1499. doi: 10.3390/cancers12061499.
  18. Paiva B, Puig N, Cedena MT, et al. Measurable Residual Disease by Next-Generation Flow Cytometry in Multiple Myeloma. J Clin Oncol. 2020 Mar 10; 38(8):784-792. doi: 10.1200/JCO.19.01231. Epub 2019 Nov 26.
  19. Garces JJ, Simicek M, Paiva B, et al. Transcriptional profiling of circulating tumor cells in multiple myeloma: a new model to understand disease dissemination. Leukemia. 2020 Feb; 34(2):589-603. doi: 10.1038/s41375-019-0588-4. Epub 2019 Oct 8.
  20. Sanoja-Flores L, Flores-Montero J, et al. Blood monitoring of circulating tumor plasma cells by next generation flow in multiple myeloma after therapy. Blood. 2019 Dec 12;134(24):2218-2222. 
  21. Paiva B, Puig N, et al. Measurable Residual Disease by Next-Generation Flow Cytometry in Multiple Myeloma. J Clin Oncol. 2019 Nov 26:JCO1901231. 
  22. Blocka J, Durie BGM, et al. Familial Cancer: How to Successfully Recruit Families for Germline Mutations Studies? Multiple Myeloma as an Example. Clinical Lymphoma Myeloma Leukemia. 2019 Oct;19(10):635-644
  23. Mithraprabhu S, Spencer A, et al. DNA-Repair Gene Mutations Are Highly Prevalent in Circulating Tumour DNA from Multiple Myeloma Patients. Cancers (Basel). 2019 Jun 29;11(7). pii: E917. doi: 10.3390/cancers11070917. 
  24. Spencer A, et al. Utility of Circulating Cell-Free RNA Analysis for the Characterization of Global Transcriptome Profiles of Multiple Myeloma Patients. Cancers (Basel). 2019 Jun 25;11(6). pii: E887. doi: 10.3390/cancers11060887. 
  25. Mithraprabhu S, Morley R, et al. Monitoring tumour burden and therapeutic response through analysis of circulating tumour DNA and extracellular RNA in multiple myeloma patients. Leukemia. 2019 Aug;33(8):2022-2033. 
  26. Puig N, Paiva B, et al. Flow cytometry for fast screening and automated risk assessment in systemic light-chain amyloidosis. Leukemia. 2019 May;33(5):1256-1267. doi: 10.1038/s41375-018-0308-5. Epub 2018 Dec 12. 
  27. L. Sanoja-Flores, J. Flores-Montero, et al. Next generation flow for minimally-invasive blood characterization of MGUS and multiple myeloma at diagnosis based on circulating tumor plasma cells (CTPC). Blood Cancer J. 2018 Dec; 8(12): 117. 
  28. Faict S, et al. Exosomes play a role in multiple myeloma bone disease and tumor development by targeting osteoclasts and osteoblasts. Blood Cancer J. 2018 Nov; 8(11): 105. 
  29. He, H et al. Successful treatment of newly diagnosed POEMS syndrome with reduced-dose bortezomib based regimen. British Journal of Haematology, 2018, 181, 122–151. 
  30. Kastritis, E, at al. Evaluation of minimal residual disease using next-generation flow cytometry in patients with AL amyloidosis. Blood Cancer Journal (2018) 8:46. 
  31. Arana, P, at al. Prognostic value of antigen expression in multiple myeloma: a PETHEMA/GEM study on 1265 patients enrolled in four consecutive clinical trials. Leukemia (2018) 32, 971–978. 
  32. Mithraprabhu, S, at al. Circulating Tumour DNA Analysis for Tumour Genome Characterisation and Monitoring Disease Burden in Extramedullary Multiple Myeloma. Int. J. Mol. Sci. 2018, 19(7), 1858. 
  33. Misiewicz-Krzeminska,I, et al.  A novel nano-immunoassay method for quantification of proteins from CD138-purified myeloma cells: biological and clinical utility. Haematologica 2018 Volume 103(5):880-889. 
  34. Rojas, A, et al. Amiloride, An Old Diuretic Drug, Is a Potential Therapeutic Agent for Multiple Myeloma. Clin Cancer Res; 23(21) November 1, 2017. 
  35. Flores-Montero J, Paiva B, Orfao, A, et al. Next generation flow (NGF) for highly sensitive and standardized detection of minimal residual disease in multiple myeloma. Leukemia. 2017 Oct;31(10):2094-2103. doi: 10.1038/leu.2017.29. Epub 2017 Jan 20. 
  36. Jelinek, T et al. Current applications of multiparameter flow cytometry in plasma cell disorders. Blood Cancer J. 2017 Oct 20;7(10):e617. doi: 10.1038/bcj.2017.90. 
  37. Mithraprabhu, S, Spencer, A et al. Circulating tumour DNA analysis demonstrates spatial mutational heterogeneity that coincides with disease relapse in myeloma. Leukemia. 2017 Aug;31(8):1695-1705. doi: 10.1038/leu.2016.366. Epub 2016 Nov 30. 
  38. Hillengass, J et al. Whole-body computed tomography versus conventional skeletal survey in patients with multiple myeloma: a study of the International Myeloma Working Group. Blood Cancer J. 2017 Aug 25;7(8):e599. doi: 10.1038/bcj.2017.78.
  39. Lahuerta JJ, Paiva B, et al. Depth of response in multiple myeloma: a pooled analysis of 609 patients enrolled in three PETHEMA/GEM clinical trials. J Clin Oncol. 2017 Sep 1;35(25):2900-2910. doi: 10.1200/JCO.2016.69.2517. Epub 2017 May 12. 
  40. Roshal M, Flores-Montero, JA, et al. MRD detection in multiple myeloma: comparison between MSKCC 10-color single-tube and EuroFlow 8-color 2-tube methods. Blood Advances 2017 1:728-732; doi:
  41. Mishima Y, Paiva B, Ghobrial I, et al. The Mutational Landscape of Circulating Tumor Cells in Multiple Myeloma. Cell Rep. 2017 Apr 4;19(1):218-224. 
  42. Quwaider, D, et al. DEPTOR maintains plasma cell differentiation and favorably affects prognosis in multiple myeloma. J Hematol Oncol. 2017; 10: 92. 
  43. Seckinger, A, et al. Target Expression, Generation, Preclinical Activity, and Pharmacokinetics of the BCMA-T Cell Bispecific Antibody EM801 for Multiple Myeloma Treatment. Cancer Cell 31, 396–410, March 13, 2017. 
  44. Paiva, B, et al. Differentiation stage of myeloma plasma cells: biological and clinical significance. Leukemia. 2017 February ; 31(2): 382–392. 
  45. Halvarsson B-M, Wihlborg A-K, et al. Direct evidence for a polygenic etiology in familial multiple myeloma. Blood Advances. 2017 1:619-623 
  46. Paiva B, Merino J and San Miguel JF. Utility of flow cytometry studies in the management of patients with multiple myeloma. Curr Opin Oncol 2016, 28:511–517. 
  47. Paiva B, et al. Minimal residual disease monitoring and immune profiling in multiple myeloma in elderly patients. Blood. 2016;127(25):3165-3174. 
  48. Paiva B, et al. Phenotypic, transcriptomic, and genomic features of clonal plasma cells in light-chain amyloidosis. Blood. 2016;127(24):3035-3039. 
  49. Paiva B, et al. Phenotypic and genomic analysis of multiple myeloma minimal residual disease tumor cells: a new model to understand chemoresistance. Blood. 2016;127(15):1896-1906. 
  50. Flores-Montero J, de Tute R, Paiva B, Perez JJ, Bottcher S, Wind H, Sanoja L, Puig N, Lecrevisse Q, Vidriales MB, van Dongen JJM and Orfao A. Immunophenotype of Normal vs. Myeloma Plasma Cells: Toward Antibody Panel Specifications for MRD Detection in Multiple Myeloma. Cytometry Part B 2016; 90B: 61–72.
  51. Pojero F, Flores-Montero J, Sanoja L, Perez JJ, Puig N, Paiva B, Bottcher S, van Dongen JM, and Orfao A on behalf of the Euroflow group. Utility of CD54, CD229, CD319 for the Identification of Plasma Cells in Patients with Clonal Plasma Cell Diseases. Cytometry Part B (Clinical Cytometry) 201690B:91–100.
  52. Paiva B, van Dongen JM, and Orfao A. New criteria for response assessment: role of minimal residual disease in multiple myeloma. Blood 2015; 125: 3059-3068 
  53. Paiva B, Chandia M, Puig N, Vidriales MD, Perez JJ, Lopez-Corral L, Ocio EM, Garcia-Sanz R, Gutierrez NC, Jimenez-Ubieto A, Lahuerta JJ, Mateos MV, and San Miguel JF. The prognostic value of multiparameter flow cytometry minimal residual disease assessment in relapsed multiple myeloma. Haematologica Feb 2015, 100 (2) e53-e55. 
  54. Matarraz S, Paiva B, Díez-Campelo M, Bárrena S, Jara-Acevedo M, Gutiérrez ML, Sayagués JM, Sánchez ML, Bárcena P, Garrastazul MP, Berruezo MJ, Duran JM, Cerveró C, García-Erce JA, Florensa L, Méndez GD, Gutierrez O, Del Cañizo MC, van Dongen JJ, San Miguel JF, Orfao A. Immunophenotypic alterations of bone marrow myeloid cell compartments in multiple myeloma patientspredict for myelodysplasia-associated cytogenetic alterations. Leukemia. 2014 Aug;28(8):1747-50.
  55. Matarraz S, et al. Myelodysplasia-associated immunophenotypic alterations of bone marrow cells in myeloma: are they present at diagnosis or are they induced by lenalidomide? Haematologica October 2012 97: 1608-1611 


  1. Puig, N, et al. Analysis of treatment efficacy in the GEM-CESAR trial for high-risk smoldering multiple myeloma patients: Comparison between the standard and IMWG MRD criteria and QIP-MS including FLC (QIP-FLC-MS).
  2. Mateos MV, et al. Curative Strategy  for High-Risk Smoldering Myeloma (GEM-CESAR): Carfilzomib, Lenalidomide and Dexamethasone (KRd) As Induction Followed By HDT-ASCT, Consolidation with Krd and Maintenance with Rd
  3. Sanoja-Flores Luzalba, Flores-Montero Juan, and Orfao Alberto1 on behalf of the EuroFlow Consortium and the International Myeloma Foundation.  Frequency and number of clonal plasma cells in peripheral blood (PB) in plasma cell neoplasm (PCN) by Next Generation Flow. XV Congress of Iberican Society of Cytometry. May 2017.  (poster presentation) 
  4. Misiewicz-Krzeminska I, et al. Quantification of proteins from CD138-purified myeloma cells using the capillary nano-immunoassay technology is a better predictor of survival than the corresponding gene expression value. 16th International Myeloma Workshop, March 1-4, 2017. 
  5. Hillengass, J et al. Findings of Whole Body Computed Tomography Compared to Conventional Skeletal Survey in Patients with Monoclonal Plasma Cell Disorders - a Study of the International Myeloma Working Group. Blood 2016 128:4468.
  6. Spencer A, Mithraprabhu S, Ramachandran M, Klarica D, Hocking J, Mai L, Walsh S, Broemeling D, Marziali A, Kalff A, Wiggin M, Durie BGM, and Khong TT. Evaluation of Circulating Tumour DNA for the Mutational Characterisation of Multiple Myeloma. Blood 2015 126:368.
  7. Misiewicz-Krzeminska I, et al. Quantification of Cyclin D1, Cyclin D2, Ikaros, Aiolos, and Cerebelon Proteins by Capilary Immunoassay in Patients with Newly Diagnosed Multiple Myeloma and Analysis of their Impact on Patient Survival. EHA21 Abstract Book (2016).
  8. Kubiczkova-Besse L, Drandi D, Sedlarikova L, Oliva S,  Gambella M, Omedè P, Adam Z, Pour L, Sevcikova S, Boccadoro M, Palumbo A, Hajek R. Cell-Free DNA for Minimal Residual Disease Monitoring in Multiple Myeloma Patients. Blood 2014 124:3423


  1. iStopMM - A Nationwide Screening Study of MGUS
    2017 ASH Conference – Friday, December 8, 2017, 3:45 PM-5:05 PM
    Sigurður Yngvi Kristinsson, MD, PhD
    Faculty of Medicine, University of Iceland, Reykjavik, Iceland



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