Liquid biopsies for multiple myeloma in a time of precision medicine

AbstractMultiple myeloma (MM) is a challenging, progressive, and highly heterogeneous hematological malignancy. MM is characterized by multifocal proliferation of neoplastic plasma cells in the bone marrow (BM) and sometimes in extramedullary organs. Despite the availability of novel drugs and the longer median overall survival, some patients survive more than 10  years while others die rapidly. This heterogeneity is mainly driven by biological characteristics of MM cells, including genetic abnormalities. Disease progressions are mainly due to the inability of drugs to overcome refractory disease and inevitable drug-resistant relapse. In clinical practice, a bone marrow biopsy, mostly performed in one site, is still used to access the genetics of MM. However, BM biopsy use is limited by its invasive nature and by often not accurately reflecting the mutational profile of MM. Recent insights into the genetic landscape of MM provide a valuable opportunit y to implement precision medicine approaches aiming to enable better patient profiling and selection of targeted therapies. In this review, we explore the use of the emerging field of liquid biopsies in myeloma patients considering current unmet medical needs, such as assessing the dynamic mutationa l landscape of myeloma, early predictors of treatment response, and a less invasive response monitoring.
Source: Journal of Molecular Medicine - Category: Molecular Biology Source Type: research

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AbstractA 74-year-old man presented with nephrotic syndrome and kidney insufficiency. Laboratory tests revealed monoclonal gammopathy of immunoglobulin A-lambda. Renal biopsy revealed diffuse mesangial proliferation and double-contoured basement membranes. Immunofluorescent analyses showed granular deposition of immunoglobulin A and C3 at the capillary walls and mesangial regions. Immunohistochemistry suggested monoclonal deposition of immunoglobulin A1-lambda. Electron microscopic analyses showed finely granular electron-dense deposits at mesangial and subendothelial areas. These findings suggested immunoglobulin A-type p...
Source: CEN Case Reports - Category: Urology & Nephrology Source Type: research
68Ga-pentixafor PET/CT in a 66-year-old woman with newly diagnosed multiple myeloma showed extensive disease in bone and bone marrow. After 6 cycles of chemotherapy, the patient was in complete remission but complained of fever and coughing. Follow-up 68Ga-pentixafor PET/CT showed significantly reduced uptake in bone and bone marrow, consistent with her clinical outcome of myeloma. However, patches, nodules, and ground-grass opacities in bilateral lungs with moderate to intense uptake of 68Ga-pentixafor were noted. The histopathology of the biopsy for the pulmonary nodule confirmed pulmonary cryptococcosis.
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Interesting Images Source Type: research
We want to thank our colleagues for this letter and for the great interest they have expressed.1,2 We agree that the diagnosis of solitary plasmacytoma is an important point; therefore, we followed the recommendations for diagnosis and treatment.3-5 We included only solitary plasmacytomas that were confirmed histologically with a biopsy and clinical workup and were absent of any features of multiple myeloma, according to guidelines.4 In particular, bone marrow biopsies were systematically performed to eliminate multiple myeloma (MM) at diagnosis and in the event of suspected myeloma progression or relapse of a new solitary plasmacytoma.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Comment Source Type: research
We read the article “Solitary plasmacytoma: Lenalidomide-dexamethasone combined with radiation therapy improves progression-free survival and multiple myeloma-free survival” with great interest.1 It offers a combined treatment for solitary plasmacytoma (SP), which has a significant risk of progression to multiple m yeloma (MM). The diagnosis of SP and elimination of MM should include biopsies from the primary lesion and bone marrow (BM), multiparameter flow cytometry, serum and urine electrophoresis, immunoglobulins (Ig), Free Light Chain assay, Bence-Jones proteins, and skeletal survey with magnetic resonance ...
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Comment Source Type: research
Authors: Funada M, Nakano K, Miyata H, Nawata A, Tanaka Y Abstract We herein report a 65-year-old man with elevated serum IgG4 levels, enlarged thyroid, and renal dysfunction, mimicking IgG4-related disease (IgG4-RD). The definitive diagnosis of IgG4-RD was not established because a tissue biopsy revealed no IgG4-positive cell infiltration or fibrosis. The presence of an M peak in the β fraction, Bence Jones protein in urine, and progressive anemia suggested multiple myeloma (MM). The κ/λ ratio was>100, tumor plasma cells were present at>20% in bone marrow, and immunostaining revealed IgG4-p...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Authors: Chung Y, Shin S, Shim H, Sohn JY, Lee DE, Lee H, Eom HS, Kim KG, Kong SY Abstract Angiogenesis is important for the proliferation and survival of multiple myeloma (MM) cells. Bone marrow (BM) microvessel density (MVD) is a useful marker of angiogenesis and an increase in MVD can be used as a marker of poor prognosis in MM patients. We developed an automated image analyzer to assess MVD from images of BM biopsies stained with anti-CD34 antibodies using two color models. MVD was calculated by merging images from the red and hue channels after eliminating non-microvessels. The analyzer results were compared w...
Source: Annals of Laboratory Medicine - Category: Laboratory Medicine Tags: Ann Lab Med Source Type: research
Publication date: Available online 14 January 2020Source: Best Practice &Research Clinical HaematologyAuthor(s): Johannes M. Waldschmidt, Tushara Vijaykumar, Birgit Knoechel, Jens G. LohrAbstractOver the past years, the emergence of liquid biopsy technologies has dramatically expanded our ability to assess multiple myeloma without the need for invasive sampling. Interrogation of cell-free DNA from the peripheral blood recapitulates the mutational landscape at excellent concordance with matching bone marrow aspirates. It can quantify disease burden and identify previously undetected resistance mechanisms which may infor...
Source: Best Practice and Research Clinical Haematology - Category: Hematology Source Type: research
ConclusionOur study did not find a statistically significant difference in the overall response rates or survival outcome measures for patients with AML and indeterminate day 14 bone marrow in the 2 treatment groups. Our findings question the utility of immediate reinduction chemotherapy and raise concern regarding overtreatment in this patient population. Larger studies investigating similar outcomes are warranted to validate our clinical findings.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: Available online 31 December 2019Source: Clinica Chimica ActaAuthor(s): Nidhi Gupta, Aparna Sharma, Alpana SharmaAbstractMultiple myeloma (MM) is the second most common hematological malignancy after non-Hodgkin lymphoma and is manifested by uncontrolled proliferation and accumulation of abnormal plasma cells in the bone marrow (BM). The incidence along with deaths associated with MM is on rise due to lack of an effective diagnosis at an early stage. The identification of MM decades ago marks the adoption of certain conventional markers such as plasma cell percentage in BM, serum protein electrophoresis f...
Source: Clinica Chimica Acta - Category: Laboratory Medicine Source Type: research
Abstract The authors here present a rare case of systemic amyloidosis with multiple myeloma. The patient was a 55-year-old man who presented with complaints of dysphagia and skin lesions. From clinical examination and endoscopic findings, gastric carcinoma was suspected and biopsy was taken from the gastric lesion. Histopathological examination of gastrointestinal biopsy revealed amyloid deposits. The patient also had multiple skin lesions, which also showed cutaneous amyloidosis. Owing to the presence of gastric amyloidosis, the patient was investigated further with serum electrophoresis and bone marrow biopsy, w...
Source: Indian Journal of Pathology and Microbiology - Category: Pathology Authors: Tags: Indian J Pathol Microbiol Source Type: research
More News: Bone Marrow Aspiration and Biopsy | Cancer & Oncology | Genetics | Hematology | Molecular Biology | Myeloma