Jon Þórir Oskarsson, MSC Discusses the First Study To Evaluate CTPC in Patients With Myeloma Precursor Conditions.
In this video, Jon Þórir Oskarsson, MSc, discusses the first study to evaluate CTPC in patients with myeloma precursor conditions.
What is the purpose of this study?
The purpose is to evaluate the feasibility of using CTPC analysis by next-generation flow cytometry (NGF) for disease monitoring in precursor conditions of multiple myeloma (MM) and early detection of progression to active MM.
What is the background of this Study?
A proportion of patients with monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) will progress to active multiple myeloma (MM). Optimization of follow-up strategies and diagnostic testing is needed to detect those who are at risk of imminent progression since they may benefit from early treatment. There is a considerable need for biomarkers that can accurately reflect disease status and risk of progression to MM. In recent years, circulating tumor plasma cells (CTPC) have gained interest in disease monitoring for their promising prognostic significance and the minimally-invasive nature of blood sampling.
Conclusion:
This is the first study evaluating CTPC in a screened cohort of patients with precursor conditions of MM. We found the frequency of CTPC detection to be lower than has been previously reported in a study by Sanoja-Flores et al.
in 2018 using the same NGF method, particularly for MGUS and SMM. This difference can likely be attributed to a higher frequency of patients with less advanced disease in the screened cohort of the iStopMM study, suggested by markedly lower median M-component levels in this study (3.3 vs 6, 7.8 vs 21, and 16.2 vs 27 g/L for MGUS, SMM, and MM, respectively). We found that the number of CTPC progressively increased from MGUS to SMM and MM.
Furthermore, a detectable CTPC population by NGF was associated with a higher percentage tumor PC in the BMPC compartment in both MGUS and SMM. A BMPC compartment that is highly dominated by tumor PC has been reported to be associated with a higher risk of progression in both MGUS and SMM and in our study a CTPC population was detected in a vast majority of SMM patients with over 95% tumor PC. Taken together, these results confirm that the detection and number of CTPC by NGF is associated with a more advanced disease and that their detection by NGF may have a clinical utility in the follow-up of myeloma precursor disease.
ASH 2021: Abstract 2645
