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IMW 2021 | Screening myeloma precursor conditions to predict progression

Maria-Victoria Mateos, MD, PhD, University of Salamanca, Salamanca, Spain, talks on the role of screening in the field of multiple myeloma, discussing how screening of patients with monoclonal gammopathies and smoldering myeloma can be used to evaluate the risk of progression to multiple myeloma. Dr Mateos talks on different screening methods, such as M-protein measurements, magnetic resonance imaging (MRI), and genomic markers which can be incorporated to improve risk assessment for progression. This interview took place during the 18th International Myeloma Workshop (IMW 2021) congress.

Transcript (edited for clarity)

We are doing a lot of work trying to do a better screening in patients with monoclonal gammopathy or smoldering myeloma. And the main reason is because it is necessary to accurate the risk of progression to multiple myeloma. This means that we are going to evaluate not only the M protein in serum, urine, as well as hemogram and biochemistry, but we have to evaluate in detail the bone marrow, the cytogenetic abnormalities, how malignant plasma cells are within the plasma cell bone marrow compartment, and we have to implement the margin assessments, not only definitely with X-ray that is obsolete, but we have to incorporate the PET/CT and MRI...

We are doing a lot of work trying to do a better screening in patients with monoclonal gammopathy or smoldering myeloma. And the main reason is because it is necessary to accurate the risk of progression to multiple myeloma. This means that we are going to evaluate not only the M protein in serum, urine, as well as hemogram and biochemistry, but we have to evaluate in detail the bone marrow, the cytogenetic abnormalities, how malignant plasma cells are within the plasma cell bone marrow compartment, and we have to implement the margin assessments, not only definitely with X-ray that is obsolete, but we have to incorporate the PET/CT and MRI. This is going to give us a whole picture about maybe all potential risk factors in order to define very well what is the risk of progression to multiple myeloma.

And in the near future, we are also to incorporate genomic markers, and we will do mutational signatures, copy number variations of well much more sophisticated genomic analysis. And these information, together with the clinical markers, will help us to ensure the risk of progression to multiple myeloma. And this is going to be definitely relevant because the management is going to be risk-adapted.

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Disclosures

Maria-Victoria Mateos, MD, PhD, has received honoraria from lectures and participated in boards with Janssen, BMS-Celgene, AbbVie, Amgen, Takeda, GSK, Sanofi, Oncopeptides, Pfizer, Regeneron, Adaptive, Roche, Bluebird-bio and Sea-Gen.