Researchers from the Cima and the Clínica Universidad de Navarrain partnership with the Hospital 12 de Octubre in Madrid, the Hospital Clínico Universitario de Salamanca and the hospitals of the Spanish Myeloma group (GEM), have coordinated an international study whose results could have clinical application in patients with multiple myeloma. The conclusions have been published in the scientific journal Journal of Clinical Oncology.

Multiple myeloma is a cancer caused by the excessive proliferation of plasma cells. It is the second most common haematological cancer, affecting approximately 77,000 people in Europe, most of them over the age of 65. Despite the progressive increase in therapeutic alternatives, there is currently a high percentage of relapses.

Minimal residual disease (MRD) is one of the prognostic factors (providing information on the future evolution of the disease) for many types of tumours, so its measurement has become a standard procedure after the application of conventional treatment. According to Dr. Bruno Paiva, researcher of Haemato-oncology at Cima and Clínica Universidad de Navarra and first author of work, "in the case of multiple myeloma it is especially necessary to implement novel and highly sensitive techniques that allow accurate measurement of MRD, which will result in a more successful therapeutic approach".

The work, coordinated by Drs. Bruno Paiva, Juan José Lahuerta and Jesús San Miguel, within the Spanish Myelomagroup , has analysed the role of state-of-the-art flow cytometry as a technique to assess EMR in multiple myeloma. It is a rapid, goal and quantitative method of cell analysis in blood, bone marrow or other tissue samples. "The study, conducted at framework of essay PETHEMA/GEM2012MENOS65, has confirmed that this technique is particularly sensitive for measuring EMR and assessing treatment efficacy, following the criteria of group International Myeloma," says Dr Paiva.

essay multicentre clinical

The clinical essay collects the data of 458 patients with newly diagnosed multiple myeloma, treated in different centres in Spain and the Netherlands. As Dr Paiva explains, "we analysed 1,100 bone marrow samples after induction and intensification and observed that 45% showed undetectable levels of MRE. In these patients, the risk of progression or death was reduced by 82%.

The study concludes that eradication of EMR to undetectable levels by new generation flow cytometry should be considered as the therapeutic goal for multiple myeloma patients who are candidates for autologous transplantation.

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  J Clin Oncol. 2020 Mar 10;38(8):784-792. doi: 10.1200/JCO.19.01231. Epub 2019 Nov 26.