Multiple Myeloma Biological Samples:
Utilization in Research and Sourcing

The development of drugs and diagnostic tests for the treatment and detection of multiple myeloma requires conducting studies on biological samples obtained from patients with multiple myeloma. A brief overview of various cancers and how the services offered by Labtoo contribute to accelerating research and development projects in the pharmaceutical industry.

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What are multiple myelomas?

Multiple myeloma, also known as Kahler's disease, manifests as a hematologic cancer characterized by abnormal proliferation of plasma cells in the bone marrow. Plasma cells originate from the terminal maturation of B lymphocytes and are dedicated to antibody synthesis. Within the context of multiple myeloma, the abnormal antibody produced is termed "M protein".

The accumulation of myelomatous cells leads to various physiological disturbances, including anemia due to reduced red blood cell production, alterations in bone structure through stimulation of bone destruction and hindered tissue regeneration, as well as influence on renal functions through increased blood viscosity.

Classification of myelomas generally occurs based on the type of M protein produced by malignant plasma cells, considering the nature of their light and heavy chains. The most common types include immunoglobulin G (IgG) and immunoglobulin A (IgA) myelomas. Less frequently, plasma cells producing immunoglobulin D or E are observed. A final variant exists where plasma cells do not produce whole antibodies but only their light chains; this is referred to as light chain myeloma.

Multiple myeloma accounts for approximately 10% of hematologic cancers and represents about 2% of all cancer cases. Currently, complete cure is generally not achieved, and the disease tends to progress to a chronic form even after treatment. It is notable that, unlike most cancers, multiple myeloma does not exhibit a propensity for metastasis formation in other organs.

Illustration of multiple myeloma
Type of Multiple Myeloma Cell of Origin Frequency
Immunoglobulin G Myeloma Plasma Cell ≈ 55%
Immunoglobulin A Myeloma Plasma Cell ≈ 20%
Immunoglobulin D Myeloma Plasma Cell > 2%
Immunoglobulin E Myeloma Plasma Cell Rare
Light Chain Myeloma Plasma Cell ≈ 15-20%

Explore Labtoo's Service for Your Biological Sample Research

Labtoo assists you in sourcing biological samples from multiple myeloma patients. Our team manages the entire project of transferring biological materials from inception to sample delivery.

  • Feasibility assessment of sample availability or clinical collection from referenced clinical centers
  • Validation of regulatory aspects
  • Establishment of a contractual framework
  • Dispatch of desired samples under appropriate conditions
  • Transfer of associated clinical data
  • Additional analytical and experimental services

Types of Available Samples

  • Tissues
    • Fresh Tissues: after a tumor resection or a biopsy, a pathologist can decide whether the tissue sample can be used for research. Labtoo can organize the conditioning and shipment of fresh myeloma tissue in 24-48 hours after surgery.

    • Frozen Tissues (OCT and FF): similarly to fresh tissue, once the tissues are cleared for research, the clinical site can freeze and keep the frozen myeloma tissue samples at -80°C or in liquid nitrogen for ulterior use.

    • FFPE Tissues: Pathologists typically embed the biopsies and resections in paraffin. FFPE blocks of myeloma tissues can be used later for research.

    • Adjacent Healthy Tissues: tumor resections typically include healthy adjacent tissue during the process. This tissue can later be used for research and act as controls for diseased tissues.

  • Blood Derivatives
    • Plasma or Serum from myeloma patients
    • PBMC (Peripheral Blood Mononuclear Cells)
    • Whole Blood
    • Leukapheresis
  • Biofluids
    • Urine
    • Feces
    • Others

Typical Associated Clinical Data

    • Age
    • Gender
    • Ethnicity
    • TNM Classification
    • Undergone Treatment
    • Medical Imaging
    • Positivity/Negativity for certain Infections
    • Other Data (upon request)

Our service identifies clinical sites capable of preparing and transferring a sample collection for a specific project.

Contact our team to discuss your project.

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The Stages and Grades of Multiple Myeloma

Multiple myeloma and solid cancers are subject to distinct classifications due to their specific characteristics. Unlike solid cancers, where the term "grade" is commonly used to describe the nature and aggressiveness of cancer cells, it is not employed in the context of myeloma.

For myeloma, classification relies on blood tests and imaging examinations. Two classification systems are commonly used: the International Staging System (ISS), which evaluates levels of albumin and beta-2 microglobulin in the blood, and the Durie and Salmon classification, which takes into account hemoglobin and calcium levels, the number of bone lesions detected by radiography, as well as the quantity of M protein in the blood or urine.

These two classifications translate as follows:

ISS Classification

  • Stage 1: It is characterized by a beta-2 microglobulin level of less than 3.5 mg/L and an albumin level greater than or equal to 35 g/L.

  • Stage 2: It has two subcategories. In the first, the beta-2 microglobulin level is less than 3.5 mg/L and the albumin level is less than 35 g/L. In the second, the beta-2 microglobulin level is between 3.5 and 5.5 mg/L, without consideration of the albumin level.

  • Stage 3: It is defined by a beta-2 microglobulin level greater than or equal to 5.5 mg/L, without consideration of the albumin level.

Durie and Salmon Classification

  • Stage 1: Presence of a small amount of myeloma cells, with a hemoglobin level equal to or greater than 100 g/L, normal calcium level, IgG level less than 50 g/L, IgA level less than 30 g/L, urinary M protein level less than 4 g, and absence of bone lesions.

  • Stage 2: Moderate amount of myeloma cells, characterized by criteria between those of stage 1 and stage 3.

  • Stage 3: Presence of a large amount of myeloma cells, associated with a hemoglobin level less than 85 g/L, calcium level less than 2.8 mmol/L, IgG level greater than 70 g/L, IgA level greater than 50 g/L, urine M protein level of 12 g, and multiple bone lesions.

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Rare Forms of Multiple Myeloma

Among the less common variants of myeloma, we find:

  • Immunoglobulin D (IgD) Myeloma

    IgD myeloma is indeed less frequent than other types of myeloma. It is characterized by the production of Immunoglobulin D. Symptoms are generally similar, but it may present distinct clinical features.

  • Immunoglobulin E (IgE) Myeloma

    IgE myeloma is often considered more aggressive. It may be associated with an increased risk of complications and progression to plasma cell leukemia. However, the rarity of this subtype makes clinical data less abundant than for other forms of myeloma.

  • Non-Secreting Myeloma

    Non-secreting myeloma is a variant where myeloma cells do not produce enough M protein to be detected by electrophoresis. This can make diagnosis more complex, often requiring imaging methods, genetic testing, or biopsies to confirm the presence of the disease.

Multiple Myeloma Treatments and Advances

Currently, medicine cannot ensure complete cure of myeloma; the goal of treatments is to control the disease, even achieving temporary remissions. The main methods employed to manage the disease include:

  • Chemotherapy: Frequently used in myeloma treatment protocols, chemotherapy aims to block the cellular division mechanisms of cancer cells. Commonly used drugs include melphalan and cyclophosphamide.

  • Radiotherapy: Relatively rarely used, radiotherapy may be prescribed when chemotherapy has not been effective.

  • Stem cell transplantation: This approach is feasible in patients under 65 years old and involves prior intensive chemotherapy to eliminate cancerous cells from the bone marrow.

  • Targeted therapy: A more recent method, targeted therapy aims to target specific proteins of the tumor. For example, the use of proteasome inhibitors blocks the activity of proteins essential for the survival of cancer cells.

Immunotherapy is not currently used in the treatment of multiple myeloma, and the results of this approach in this context remain limited. Research continues to evaluate the effectiveness of new therapeutic strategies and improve the management of this disease.

 

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