Researchers at Cima University of Navarra have developed a calculator that identifies patients with multiple myeloma and primary systemic amyloidosis who have a better prognosis by having a more benign profile . This system, designed in partnership with the Spanish Myeloma group (GEM-PETHEMA), will help to better classify patients and could avoid unnecessary treatment for this group of patients.

Multiple myeloma is the second most common hematological cancer. It is a very heterogeneous blood subject , so patients present very different clinical behavior and response to treatment. "Through flow cytometry we have identified a subgroup of patients, both symptomatic and asymptomatic, who have a profile similar to that seen in subjects with benign myeloma precursor disease, called monoclonal gammopathy of uncertain significance (MGUS). Likewise, we have also found this subgroup of patients in another related hematologic disease, primary systemic amyloidosis," explains Dr. Bruno Paiva, co-director of the Hemato-Oncology Program at Cima, integrated in the Cancer Center Clínica Universidad de Navarra, and director of the study.

The researchers have developed a freely accessible onlinetool that allows any hematologist in the world to classify their patients using routine flow cytometry data . This technique discriminates residual normal plasma cells and tumor cells with high accuracy. "Thanks to the bigdata generated for more than ten years by GEM-PETHEMA, particularly at the Cancer Center Clínica Universidad de Navarra, the University Hospital of Salamanca and the Hospital 12 de Octubre in Madrid, we have developed this calculator, which identifies patients with benign profile (GMSI) in real time and predicts their survival according to different clinical-biological characteristics," says Dr. Paiva. The results of this research, validated in international series of patients from the United States, the Czech Republic and Italy, have been published in the Journal of Clinical Oncology, the scientific journal with the highest impact in oncology.

Clinical application

This tool is very useful for both asymptomatic patients and those with active multiple myeloma. As explained by researcher at Cima, "in the case of asymptomatic individuals, even if they have other risk factors, this subgroup has a very high probability of progression leave. In fact, after comparing with other patients who have been treated before developing symptoms, we have seen no change in disease progression".

In the subgroup with active multiple myeloma and benign profile , 80% of patients sample were progression-free fees at 5 years after intensive treatment with bone marrow transplantation and chemotherapy. "Moreover, surprisingly, stopping treatment does not increase the risk of progression, even in those patients who had not achieved complete remission," notes Dr. Paiva. Therefore, this calculator could be useful in identifying patients in whom a partial response to treatment should not be considered suboptimal, "and who probably do not require overtreatment."

The researchers confirmed the efficacy of this tool also in a group of patients with primary systemic amyloidosis, a very rare hematological malignancy with low survival fees .

"Our calculator is the result of more than a decade of cooperative work in Spain and partnership with other international centers. We now make it available at academic community to improve the approach to these hematologic diseases," concludes Dr. Paiva.

This research is part of the high school de research Sanitaria de Navarra (IdiSNA), the Cancer Center (CIBERONC) and the group Spanish Myeloma and has public and private funding as Iberdrola, through the association Spanish Against Cancer, within its call for "Ayudas Accelerator" (project publisher ).

reference letter bibliographic

→ Journal of Clinical Oncology. 2023 Mar 17; JCO2201916. doi: 10.1200/JCO.22.01916.