What Is Multiple Myeloma?
Multiple myeloma (MM), although rare (1), is the second most common blood cancer worldwide (2). It originates from bone marrow plasma cells, thus impacting regions where bone marrow is active, such as bones, blood, kidneys, and the immune system (2).
Multiple myeloma is complex, as it’s difficult to diagnose properly and has a complex guidelines schema (3, 4, 5). Cerba Research has you covered with a wide range of international multiple myeloma working group (IMWG) offerings that utilize cutting-edge techniques. As one of our sponsors said, “consistency of data can make or break an asset, which is why we prefer partnering with Cerba Research for MM IMWG testing.” Contact us to find out.
Cerba Research Multiple Myeloma Services
Our multiple myeloma specialists support a wide range of MM studies from discovery / preclinical (data not shown) to phase III registration trials and beyond. Most (95%+) of our projects include specialty testing, such as, but not limited to, flow cytometry (FCM), cytogenetics, qPCR, ddPCR, NGS comprehensive myeloma panels, 250+ IHC simplex and multiplex protocols, cytogenetics, and more.
Our Areas Of Expertise In Multiple Myeloma
Did you know that we can cover a wide range of multiple myeloma biomarkers and clinical features? Check out our mapping exercise by select MM features against our Cerba Research offerings (2-5).
MM Biomarkers | Most Commonly Deployed Technics | Additional Assays | Cerba Research Offerings |
---|---|---|---|
Structural (unbalanced) |
Cytogenetics, FISH |
OGM, NGS |
Cytogenetics, FISH |
Structural (balanced) |
Cytogenetics, FISH |
OGM, NGS |
Cytogenetics, FISH |
TP53 |
FISH, NGS |
FISH, PCR, NGS |
|
CXCR4 |
NGS |
NGS |
|
MYD88 |
PCR |
ddPCR, NGS |
MM Biomarkers | |
---|---|
Most Commonly Deployed Technics |
Cytogenetics, FISH |
Additional Assays |
OGM, NGS |
Cerba Research Offerings |
Cytogenetics, FISH |
MM Biomarkers | |
---|---|
Most Commonly Deployed Technics |
Cytogenetics, FISH |
Additional Assays |
OGM, NGS |
Cerba Research Offerings |
Cytogenetics, FISH |
MM Biomarkers | |
---|---|
Most Commonly Deployed Technics |
FISH, NGS |
Additional Assays | |
Cerba Research Offerings |
FISH, PCR, NGS |
MM Biomarkers | |
---|---|
Most Commonly Deployed Technics |
NGS |
Additional Assays | |
Cerba Research Offerings |
NGS |
MM Biomarkers | |
---|---|
Most Commonly Deployed Technics |
PCR |
Additional Assays | |
Cerba Research Offerings |
ddPCR, NGS |
MM Biomarkers (CRAB Features) | Details | Assays | Cerba Research Offerings |
---|---|---|---|
Increased calcium levels |
>11.5 mg/dL |
Routine |
X |
Renal insufficiency |
Creatinine >2 mg/dL CrCl <40 mL/min |
Routine |
X |
Anemia |
Hb <10 g/dL or 2 g/dL less than normal |
Routine |
X |
Presence of bone lesions |
Presence of one or more osteolytic lesions |
Skeletal radiography, whole-body MRI or whole-body FDG PET/CT |
MM Biomarkers (CRAB Features) | |
---|---|
Details |
>11.5 mg/dL |
Assays |
Routine |
Cerba Research Offerings |
X |
MM Biomarkers (CRAB Features) | |
---|---|
Details |
Creatinine >2 mg/dL CrCl <40 mL/min |
Assays |
Routine |
Cerba Research Offerings |
X |
MM Biomarkers (CRAB Features) | |
---|---|
Details |
Hb <10 g/dL or 2 g/dL less than normal |
Assays |
Routine |
Cerba Research Offerings |
X |
MM Biomarkers (CRAB Features) | |
---|---|
Details |
Presence of one or more osteolytic lesions |
Assays |
Skeletal radiography, whole-body MRI or whole-body FDG PET/CT |
Cerba Research Offerings |
MM Biomarkers (Slim Features) | Details | Assay | Cerba Research Offerings |
---|---|---|---|
% Clonal plasma cells |
Sixty%+ clonal plasma cells in BM |
% clonal bone marrow plasma cells |
X |
Free light chain ratio |
Ratio of 110+ with the involved FLC ≥ 100 md/dL |
Serum FLC assay, along with sPEP, uPEP |
X |
MRI |
1+ focal marrow (non-osteolytic) lesion |
MRI |
MM Biomarkers (Slim Features) | |
---|---|
Details |
Sixty%+ clonal plasma cells in BM |
Assay |
% clonal bone marrow plasma cells |
Cerba Research Offerings |
X |
MM Biomarkers (Slim Features) | |
---|---|
Details |
Ratio of 110+ with the involved FLC ≥ 100 md/dL |
Assay |
Serum FLC assay, along with sPEP, uPEP |
Cerba Research Offerings |
X |
MM Biomarkers (Slim Features) | |
---|---|
Details |
1+ focal marrow (non-osteolytic) lesion |
Assay |
MRI |
Cerba Research Offerings |
IMWG MRD Criteria | Details | Most Commonly Deployed | Cerba Research Offerings |
---|---|---|---|
Flow MRD-negative |
Absence of phenotypically aberrant clonal plasma cells on BMAs |
FCM (EuroFlow or validated equivalent) |
FCM (EuroFlow) |
IMWG MRD Criteria | |
---|---|
Details |
Absence of phenotypically aberrant clonal plasma cells on BMAs |
Most Commonly Deployed |
FCM (EuroFlow or validated equivalent) |
Cerba Research Offerings |
FCM (EuroFlow) |
BM=bone marrow; BMA=bone marrow aspirate; ddPCR: digital droplet PCR; FCM=flow cytometry; FISH=fluorescence in situ hybridization; FLC=free ligh chain; Hb: hemoglobin; MM=multiple myeloma; MRD=minimal residual disease; MRI=magnetic resonance imaging; NGS=next-generation sequencing; OGM=optical genome mapping; sPEP=serum protein electrophoresis; uPEP=urine protein electrophoresis
What Is IMWG Recommending For The Diagnosis Of MM Aligned With Cerba Research Offerings?
CBC with differential and peripheral blood smear review
Nephelometric quantitation of immunoglobulins
Chemistry panel including calcium and creatinine
Routine urinalysis, 24h urine collection for proteinuria, eletrophoresis & immunofixation
Serum protein electrophoresis, immunofixation
Quantification of both urine M-component level & albuminuria
References
1. Orphanet: The portal for rare diseases and orphan drugs. URL [https://www.orpha.net].
2. International Myeloma Foundation: What is multiple myeloma? URL [https://www.myeloma.org/what-is-multiple-myeloma].
3. National Comprehensive Cancer Network®: NCCN guidelines, treatment by cancer type. URL [Treatment by Cancer Type (nccn.org)].
4. Rajkumar SV, Dimopoulos MA, Palumbo A, Blade J, Merlini G, Mateos MV, Kumar S, Hillengass J, Kastritis E, Richardson P, Landgren O, Paiva B, Dispenzieri A, Weiss B, LeLeu X, Zweegman S, Lonial S, Rosinol L, Zamagni E, Jagannath S, Sezer O, Kristinsson SY, Caers J, Usmani SZ, Lahuerta JJ, Johnsen HE, Beksac M, Cavo M, Goldschmidt H, Terpos E, Kyle RA, Anderson KC, Durie BG, Miguel JF. International Myeloma Working Group updated the criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014 Nov;15(12):e538-48. doi: 10.1016/S1470-2045(14)70442-5. Epub 2014 Oct 26. PMID: 25439696.
5. Kumar S, Paiva B, Anderson KC, Durie B, Landgren O, Moreau P, Munshi N, Lonial S, Bladé J, Mateos MV, Dimopoulos M, Kastritis E, Boccadoro M, Orlowski R, Goldschmidt H, Spencer A, Hou J, Chng WJ, Usmani SZ, Zamagni E, Shimizu K, Jagannath S, Johnsen HE, Terpos E, Reiman A, Kyle RA, Sonneveld P, Richardson PG, McCarthy P, Ludwig H, Chen W, Cavo M, Harousseau JL, Lentzsch S, Hillengass J, Palumbo A, Orfao A, Rajkumar SV, Miguel JS, Avet-Loiseau H. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol. 2016 Aug;17(8):e328-e346. doi: 10.1016/S1470-2045(16)30206-6. PMID: 27511158.
Discover Our Expertise In Transforming Research For Your Multiple Myeloma Treatments
We recommend starting engagement with our scientific team early, such as at the protocol design phase, for optimal results. Reach out to us here.