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Detection of tumor-specific marker for minimal residual disease in multiple myeloma patients.

AIMS
Multiple myeloma (MM), the second most common hematological cancer, is a lymphoproliferative disease of terminally differentiated B lymphocytes characterized by expansion of monoclonal plasma cells. With the introduction of new drugs, MM has become a hard-to-treat disease. The aim of treatment is clinical remission and eradication of clinical manifestations but most MM patients eventually relapse. For this reason, more accurate monitoring of remission and relapse using molecular biology techniques is at the center of attention.


METHODS
For monitoring, we used allele-specific PCR and quantitative real-time PCR based on specific detection of VDJ immunoglobulin heavy chain gene rearrangement of clonal cells for monitoring. The hypervariable region of IgH rearrangement is used for detection of minimal residual disease (MRD) in MM as this sequence is used for allele-specific primers and probe design. This technique is a complementary tool for flow cytometry in MRD detection; however, it has not been established in the Czech Republic so far.


RESULTS
Qualitative and quantitative MRD detection was performed in 50% (5/10) patients and qualitative MRD detection in another 3 oligoclonal patients.


CONCLUSIONS
Next to flow cytometry, detection of MRD by qPCR is a viable option and has been introduced in the Czech Republic.