Iceland Screens, Treats, or Prevents Multiple Myeloma 

The First Large-Scale Screening Study in the Field of Myeloma

"No one has done anything like this before, ever" said iStopMM principal investigator, Dr. Sigurdur Y. Kristinsson of the University of Iceland. 

What Is iStopMM?  

The iStopMM program is an ambitious research project supported by the International Myeloma Foundation (IMF) and led by Sigurdur Kristinsson (Professor of Hematology, University of Iceland — Reykjavik, Iceland). Started in 2016 (and officially launched in 2017), the goal of iStopMM has been to screen the population of Iceland for the presence of MGUS — the precursor state to smoldering multiple myeloma (SMM) — or for the presence of active myeloma.  

Screening a whole country for precursors of myeloma is a bold effort to truly understand the origins of myeloma and what causes it, and as the name indicates, how to prevent progression and intervene early to achieve best results if active disease is emerging.

What Does iStopMM Stand For?  

Iceland Screens, Treats, or Prevents Multiple Myeloma  

Who Funds iStopMM?  

The International Myeloma Foundation (IMF) funds this first large-scale screening study, through funding from generous donors and sponsors. In addition, multiple separate entities have provided further support including major financial contributions from The Binding Site (now Thermo Fisher Scientific) to conduct the testing of blood samples for the presence or absence of myeloma protein.  

The iStopMM project is based at the deCODE Genetics facility, which is linked to the University of Iceland. deCODE Genetics has performed full genetic sequencing for the population of Iceland. This effort is a huge benefit in the research analyses to discover potential causes or predisposing or risk factors of myeloma. Other governmental agencies and private donors have supported aspects of this exciting project. 

Why Iceland? 

Iceland is a highly favorable location for the iStopMM project for the following reasons: 

  1. The total population is not too large (less than 400,00), making it manageable to reach out to all Icelandic residents by social media and/or mail. 
  2. The population of Iceland historically has been very responsive to public health efforts, e.g., the country’s genetic sequencing project. For this reason, researchers were optimistic that many Icelanders would participate in iStopMM. 
  3. Iceland has an excellent healthcare system with electronics medical records stored from a person’s birth through the end of life. Also, most Icelanders have had blood testing performed. Therefore, samples are already available for research purposes if informed consent is obtained. The availability of these already collected samples simplified the process of contacting individuals for informed consent. 
  4. Finally, the population of Iceland is fairly homogenous; and therefore, can be studied as a group. 

What Happens in This Study?  

The primary objective is to screen all individuals over age 40 years for the presence or absence of a myeloma protein (also known as the M-protein, M-component, or M-spike). Thus far, over half the population of Iceland, representing over 80,000 individuals, have signed informed consent to participate in the iStopMM project. Over 4,000 new cases of MGUS, SMM, or active myeloma have been identified. These cases have been randomized into three arms of the study:  

Arm 1) No further follow-up is required. 

Arm 2) Enhanced testing will be conducted. 

Arm 3) Interventions will be made as appropriate. 

After five years of this study in progress, many results of its outcomes are now available. Read through the timeline below to catch up with the five-year history of iStopMM.

Iceland Winter Coast Landscape
Learning from Iceland's Model for Genetic Research

The Scandinavian island’s unique combination of genetic homogeneity, genealogical tradition, and high participation in research make it a prime location for discovery and validation of drug targets.

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