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EMN 2021 | MRD monitoring for myeloma

Bruno Paiva, PhD, University of Navarra, Pamplona, Spain, shares a summary of his talk on measurable residual disease (MRD) at EMN 2021. Dr Paiva discusses the many methods available for monitoring MRD and features of disease biology, such as mass spectrometry for measuring M-proteins or flow cytometry for measuring phenotypically aberrant cells. Dr Paiva describes how MRD is recognized as a key prognostic factor in all settings of myeloma, with increasing focus on sustained MRD and growing interest in the biology of MRD clones. This interview took place during the 2021 European Myeloma Network (EMN) congress.

Transcript (edited for clarity)

In the next EMN meeting, I will tell, I will talk about MRD – how, when and what then. And I’ve structured my presentation around four or five key points. The first is that we have nowadays a large number of methods to monitor MRD in blood and marrow, and even measuring multiple features of disease biology from the M-protein, using mass spectrometry, phenotypically aberrant cells using flow cytometry, clonotypic cells using NGS and metabolically active cells using XTT...

In the next EMN meeting, I will tell, I will talk about MRD – how, when and what then. And I’ve structured my presentation around four or five key points. The first is that we have nowadays a large number of methods to monitor MRD in blood and marrow, and even measuring multiple features of disease biology from the M-protein, using mass spectrometry, phenotypically aberrant cells using flow cytometry, clonotypic cells using NGS and metabolically active cells using XTT. And this is resulting in powerful risk stratification, according to patient’s MRD status.

In fact, based on a large, recent meta-analysis, it was shown again, that MRD is perhaps the most relevant prognostic factor in myeloma, applicable to all disease settings. Also, there is a growing focus on the value of sustained negative MRD to truly identify patients that may achieve long-term survival. And finally, there is also growing interest in the black box of the biology of MRD clones to understand the mechanisms of ultra-treatment resistance based on the biology of diagnostic and MRD cells from the same patients.

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