Comparison of detection methods for minimal residual disease in multiple myeloma and study of chromosome Y stability as a potential novel treatment response marker

This project is a collaboration between researchers in Cork University Hospital (CUH), Munster Technological University (MTU) and University College Cork (UCC). From Left to right: Dr Tom Moore (UCC), Dr Vitaliy Mykytiv (CUH/UCC), Dr Fiona O’Halloran (MTU), Aisling O’Brien (CUH/MTU)

Multiple myeloma (MM) is the second most common haematological cancer, having doubled in frequency in the last 20 years. Current treatment strategies, including prolonged maintenance chemotherapy, have significantly improved the survival of MM patients. However, despite the development of new treatment options, MM remains incurable, with most patients who achieve remission eventually relapsing due to minimal residual disease (MRD). This relates to the small number of cancer cells that might remain after treatment.

As the options for therapy continue to expand, advances in response assessment become more critical, which means there is a need for more sensitive detection methods. The key to successful management of MM patients in remission is the early detection of MRD.

MRD detection currently requires a bone marrow aspiration which can be traumatic for the patient. Moreover, the sample can be of poor quality, leading to a false-negative result due to haemodilution or patchy bone marrow involvement.

This study aims to investigate methods, particularly Next-Generation Flow Cytometry, that could potentially achieve the necessary sensitivity to monitor MRD in peripheral blood samples. This would help to increase the frequency of testing, and as blood sampling is less invasive than bone marrow sampling, it would be less traumatic for the patient. In addition, the study will  investigate the integrity of the Y chromosome in samples from male MM patients, which could potentially be a novel prognostic marker in this population.