High sensitivity blood-based M-protein detection in sCR patients with multiple myeloma

Blood Cancer J. 2017 Aug 25;7(8):e590. doi: 10.1038/bcj.2017.75.

Abstract

We assessed the ability of a mass spectrometry-based technique, called monoclonal immunoglobulin rapid accurate mass measurement (miRAMM), to extend the analytical range of M-protein detection in serum samples obtained from myeloma patients in stringent complete response (sCR) post-autologous stem cell transplant (ASCT). To aid the M-protein detection post ASCT, the accurate molecular mass of the M-protein light chain at diagnosis was determined in all patients (N=30) and used to positively identify clones in the sCR serum. Day 100 post-ASCT, sCR samples had miRAMM identifiable M-proteins in 81% of patients. Patients who had achieved only a partial remission (PR) pre-ASCT and those with IgG isotypes serum samples had the highest rate of M-protein detection by miRAMM. miRAMM positivity at single time points (day 100, 6 months or 12 months) did not correlate with progression-free survival (PFS). In contrast, sCR patients who did not decrease their miRAMM M-protein intensities in serial measurements had shorter PFS than those whose miRAMM intensities decreased (median 17.9 months vs 51.6 months; P<0.0017). miRAMM M-protein is a more sensitive blood-based test than traditional M-protein tests and could cost effectively aid in serially monitoring complete remission for continue response or biochemical relapse.

MeSH terms

  • Adult
  • Aged
  • Autografts
  • Female
  • Glycoproteins / blood*
  • Humans
  • Immunoglobulin G / blood
  • Male
  • Mass Spectrometry
  • Middle Aged
  • Multiple Myeloma / blood*
  • Multiple Myeloma / therapy*
  • Remission Induction
  • Retrospective Studies
  • Stem Cell Transplantation*

Substances

  • Glycoproteins
  • Immunoglobulin G
  • protein M (glycoprotein)