A new blood test makes it easier to proceed with multiple myeloma

A new method makes it much easier to track the progression of multiple myeloma, a type of blood cancer. With one drop of blood, it is possible to truly show whether the number of cancer cells in the bone marrow is increasing in patients. Over time, this blood test could replace a conventional bone marrow puncture.

Researchers at Radboud university medical center, in collaboration with Erasmus MC, have taken an important step towards implementing this new diagnosis, with a study published in Clinical chemistry. Multiple myeloma is a serious form of blood cancer. Every year, in Holland, around 1,000 people become infected. Better treatments have made it possible to keep the disease under long-term control in a growing number. In some patients it even goes so well that no infection can be measured in the blood.

However, this does not mean that the malignant cells are gone. These patients often reach a state of lower infectious disease. Whether this is so is currently measured by a bone marrow puncture. This is an unpleasant procedure for patients. Moreover, the test is not sensitive enough.

The disease is found almost everywhere in the bone marrow, but in some areas there are more cancerous cells than in others. So if you have a biopsy where there are fewer cancer cells, the test results do not accurately show the true condition. “

Hans Jacobs, Medical Immunologist and Last Author

That is why there is a clinical need for a good, reliable alternative. This is what Hans Jacobs, Pieter Langerhorst’s PhD student and Erasmus MC colleagues found in a blood test using mass spectrametry. This test can measure specific molecules, which come from cancer cells, in the blood. These molecules indicate that the cancer cells are in just a blood drop. This allows you to see very quickly whether the number of cancer cells in the body, or the activity of a disease, is increasing. Treatment (for example, medication or chemotherapy) can then be started more quickly if necessary.

Multiple myeloma: errors in cell division

Multiple myeloma is an uncontrolled division of malignant white blood cells (plasma cells) in the bone marrow. Healthy plasma cells make antibodies, which protect us from disease and bacteria. In patients with multiple myeloma, something goes wrong with the division of the cells, causing a malignant proliferation of plasma cells in the bone marrow. These cancer cells make infectious antibodies, also called M-proteins, which then end up in the blood.

Unique barcode for patients

Each M-protein contains an area that is unique to the cancer cells and the patient. This particular “barcode” differentiates the healthy antibodies from those made by the cancer cells. The research, partially enabled by KWF, showed that this barcode makes it possible to measure disease activity 1,000 times more sensitively than we are used to routine blood tests. In the current study, the scientists investigated whether the barcode in all patients was suitable for measurement with mass spectrametry.

Pieter Langerhorst: “We were able to use an international database of more than Multiple Myeloma 600. In all patients we were able to find a suitable barcode that was specific to patients, making Our new blood test is relevant in all patients.This is longer than we expected .. With this study, we are taking an important step towards personal diagnosis for patients with multiple myeloma. In the years to come, we want to do more research in the hope that this method can be used in the clinic over time. “