Dr. Shaji Kumar on New Criteria for Response and MRD Assessment in Multiple Myeloma

Shaji Kumar, MD, professor of Medicine, Mayo Clinic, discusses the International Myeloma Working Group’s recently released updated consensus criteria for response and minimal residual disease (MRD) assessment in multiple myeloma.

The new criteria now incorporate next-generation sequencing, or the flow-cytometry—based assessment, of MRD, explains Kumar. This looks at MRD in the bone marrow. However, it is also known that myeloma can occur outside of the bone marrow, so PET scanning has also been incorporated to address that, he said.

There may be MRD that is still not picked up with these two techniques, so there are going to be a lot of improvements on the horizon, in terms of looking at more sensitive ways of sampling the bone marrow, said Kumar.

One of the most exciting possibilities is looking at these myeloma cells, or cell-free DNA in the peripheral blood/ In addition, there are new imaging techniques, such as PET MRI, that are being considered and there is also going to be a certain isotope specifically targeted to myeloma cells that could also be a beneficial new companion with the PET scan, said Kumar.