Multiple Myeloma

Multiple Myeloma (MM) evolves in an individual from a small population of abnormal plasma cells (PCs) producing monoclonal protein detectable in the blood. This precursor condition of undetermined significance is at the initiation to widespread and lethal disease through a series of changes, both as natural progression and under treatment pressure. Initiation occurs in the bone marrow (BM) as a result of the clonal expansion of resident PCs yet the timing and triggers of these events is currently unknown. The ability to detect precursor states through a blood draw is of great clinical significance, especially in smoldering multiple myeloma (SMM), where registrational trials are underway that could lead to an FDA approved treatment that will revolutionize our standard of care approach to precursor states. Early detection of SMM through a blood draw may allow for the correct identification of candidates for early treatment intervention. 

Morphological characterization of BCMA+ cells in PB samples: (A) Representative candidate rare cells with comparative BCMA and CD138 expression across different cell sizes. (B) UMAP projection of all candidate cells using all 761 single-cell morphology and marker intensity features, colored by CD138 expression. (C) UMAP projection, colored by BCMA expression. (D) UMAP projection, colored by CD45 expression. (E) Density plots showing channel intensities for each disease state.

• Ndacayisaba L, Rappard K, Shishido S, Setayesh S, Tang G, Lin P, Matsumoto N, Hsu C, Nevarez R, Ruiz C, Naghdloo A, Yang E, Kelly K, Hicks J, Mason J, Orlowski R, Manasanch E, Kuhn P. Characterization of BCMA expression in circulating rare single cells of patients with plasma cell neoplasms. Int. J. Mol. Sci. 2022, 23(21), 13427.