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.

 

Multiple Myeloma

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.

CD138 Positivity In Multiple Myeloma

Our Experience In The Multiple Myeloma Landscape

60+

MM trials in the past 10 years

95%+

Of MM trials with specialty testing(s) and 45+ PBMC isolation network labs

DNA

176

Genes with our Cerba NGS extended panel for hematological malignancies

250+

Histopathology analysis with markers such as CD138, kappa, lambda run in CLIA accredited laboratories

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  (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 (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
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)

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

Kappa/Lambda Positivity In Plasma Cell Myeloma

What Is IMWG Recommending For The Diagnosis Of MM Aligned With Cerba Research Offerings?

Complete Blood Count (CBC)

CBC with differential and peripheral blood smear review

Immunoglobulins

Nephelometric quantitation of immunoglobulins

Chemistry Panel

Chemistry panel including calcium and creatinine

Urinalysis

Routine urinalysis, 24h urine collection for proteinuria, eletrophoresis & immunofixation

sPEP

Serum protein electrophoresis, immunofixation

M-component

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.

We recommend starting engagement with our scientific team early, such as at the protocol design phase, for optimal results. Reach out to us here.