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IMS 2025 | Methods for using mass spectrometry in the PB versus MRD in the bone marrow in multiple myeloma
Noemí Puig, MD, PhD, University Hospital Salamanca, Salamanca, Spain, discusses different methods of mass spectrometry to detect multiple myeloma–derived monoclonal proteins in the peripheral blood, comparing these methods with the analysis of measurable residual disease (MRD) in the bone marrow. She highlights that more data is needed to ensure mass spectrometry can reach the same sensitivity and specificity of MRD in the bone marrow. This interview took place at the 22nd International Myeloma Society (IMS) Annual Meeting in Toronto, Canada.
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Transcript
We have been working with a platform. So there are different platforms that use mass spectrometry to identify the monoclonal protein as a tumor marker in patients with multiple myeloma. So the one that we have been using in our studies is a MALDI-TOF-based platform, which is as compared to the alternative ones, which are clonotypic peptide methods. So this method that I mentioned is less sensitive, but is more easily applicable in the routine clinical practice, whereas the alternative methods, as I said, they are technically more complicated, technically more laborious, but more sensitive as well...
We have been working with a platform. So there are different platforms that use mass spectrometry to identify the monoclonal protein as a tumor marker in patients with multiple myeloma. So the one that we have been using in our studies is a MALDI-TOF-based platform, which is as compared to the alternative ones, which are clonotypic peptide methods. So this method that I mentioned is less sensitive, but is more easily applicable in the routine clinical practice, whereas the alternative methods, as I said, they are technically more complicated, technically more laborious, but more sensitive as well. So I guess if we want to talk about mass spectrometry, we have to specify what method we are talking about. But in any case, so the results that we have with MALDI-TOF mass spec, with the one that we have used with no liquid chromatography beforehand. So we have seen that as compared to the analysis of MRD in the bone marrow, mass spectrometry is a little bit less sensitive and a little bit less specific. So, you know, we would need one more log of sensitivity using this type of mass spectrometry to be fully comparable with the results that we obtain in the bone marrow to assess MRD. So with regards to the alternative methods, to the methods I use, the clonotypic peptide, I think these alternative methods can probably reach the sensitivity that we see in the bone marrow. I think we need more data in that regard, but things look like that. But so what we need to confirm is that the results obtained with these alternative mass spectrometry methods, as I said, have a comparable clinical value as compared to the analysis of MRD to the plasma cells in the bone marrow. And I think this will come in the next year, hopefully. And so have all the data to make a comparison between the both methodologies.
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