Myeloma
Myeloma is cancer of the white blood cells called plasma cells that are produced in the bone marrow and normally function to produce antibodies and fight infection. Myeloma is diagnosed in over 20,000 Americans per year. Overgrowth of the plasma cells causes lesions in the surrounding bone, weakens the immune system, and interferes with production of platelets, red cells and other white blood cells. The name multiple myeloma indicates more than one site of bone is affected. There are numerous medical and laboratory factors to classify newly-diagnosed patients into a standard-risk group or a higher-risk group for whom more aggressive treatment might be appropriate. Treatments include chemotherapy, targeted drug therapy, radiation, and transplant of patient’s own stem cells or bone marrow from another donor. Plasma cell dyscrasia is another term for multiple myeloma and related disorders.
Role of our laboratory tests
- Morphology studies in myeloma are performed by a pathologist who examines bone marrow cells under the microscope for excess of plasma cells, immature cells, and other abnormalities. Colored stains are used to differentiate the cell types and fluorescently-labeled tags can be used to look for specific markers on the cells.
- Cytogenetics is analysis of chromosomes in individual marrow cells. Myeloma cells are prone to many defects of extra, missing, or rearranged chromosomes especially involving chromosomes 1, 3, 5, 9, 13, 14, and 17. Certain combinations of changes are associated with milder disease, and some correlate with a more serious prognosis. The photographed, ordered spread of analyzed chromosomes is called a karyotype.
- FISH, or fluorescence in situ hybridization, uses fluorescent DNA probes and microscopy to scan the chromosomes of a large number of cells for changes that may be too infrequent or too subtle to detect by cytogenetics. FISH analyzes only chromosome regions the laboratory targets, while cytogenetics provides an overview of all chromosomes at the same time.
- Plasma cell enrichment may be done before a FISH panel. This employs magnetic beads to sort and concentrate the plasma cells to optimize detection of abnormalities.
- Flow cytometry is a high-capacity, automated method of examining the inner contents and outer surface of cells in a patient’s sample. Fluorescent dyes stain the DNA to measure growth rate and stage. Fluorescently-labeled antibodies can attach to surface targets on the patient’s cell. The labeled patient cells are passed though a laser and a set of sensors that capture and process the fluorescence information into a pattern that reveals clusters of different cells within the original patient sample.
- MyPRS™ Myeloma Prognostic Risk Signature™, offered by NeoGenomics, is a new development in genomic medicine. This test profiles the expression of 70 key genes related to a patient’s prognosis to provide the physician a risk score that is personalized for his or her patient.
Recent Research Highlights
Support and Information Resources
- International Myeloma Foundation
The IMF’s mission is to improve the quality of life of myeloma patients while working towards prevention and a cure. With over 196,000 members in 113 countries worldwide, the IMF is the oldest and largest organization dedicated to finding a cure for myeloma.
- Multiple Myeloma Research Foundation
The MMRF relentlessly pursues innovative means that accelerate the development of next-generation multiple myeloma treatments to extend the lives of patients and lead to a cure.
Clinical trials
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