In the current issue of the journal Science there is a special section called "Single-Cell Biology" (cells go solo). It is now technically feasible to study individual cells in great detail at the molecular, metabolic and functional levels. What is being discovered is that a reading of the "average" from 100, 1,000 or a million cells as has previously been done disguises the great diversity at the individual cell level. 
 
This raises the question: Are there high-risk genetic features in myeloma cells? 
 
The answer turns out to be yes and no! Some do and some don't have really abnormal genetic profiles. Discovering the ones that do can guide us to the next phase of therapy for myeloma patients. 
 
This is significant for the International Myeloma Foundation's signature project, the Black Swan Research Initiative, which is directed towards finding a cure for myeloma. If a myeloma patient's treatment produces an excellent result, with achievement of Minimal Residual Disease (MRD) Zero (no detectable myeloma), follow-up monitoring is required. Although it is hoped and assumed that many patients will have sustained MRD-Zero and may be cured, some will not be cured with the first attempt. These patients will start to have single cells of myeloma detectable by flow cytometry on MRD testing. 
 
Studies of these single residual myeloma cells will provide the clues needed to eradicate the cells with new alternate and/or higher dose therapy. Checking cells one by one, as BSRI team members Dr. Alberto Orfao and Dr. Ola Landgren are now able to do, will illustrate the diversity and need most likely for a combination approach to eradicate all these residual myeloma cells. This new technology for single-cell analyses can be key in coming up with the answers to achieving cure! And it is just another piece of the puzzle that is the BSRI, a multifaceted approach to cure myeloma. 
 
To learn more, stay tuned as we update with blogs, teleconferences, and reports in 2014. 
 
Dr. Durie sincerely appreciates and reads all comments left here. However, he cannot answer specific medical questions and encourages readers to contact the trained IMF Hotline staff instead. Questions are answered with input from Dr. Durie and/or other scientific advisors and IMWG members as appropriate. To contact the IMF Hotline, call  800-452-CURE, toll-free in the US and Canada, or send an email to hotline@myeloma.org. Hotline hours are 9 am to 4 pm PST. Thank you.
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