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Tracking Infection in Myeloma
Though NDMM patients might not know it, tracking infection in myeloma is central to each patient’s battle with their incurable blood cancer. According to research, approximately 45% of all early deaths result not from the MM itself but from infections.
As cancers go, multiple myeloma is a somewhat unique cancer in that it is a cancer of the immune system. This is because MM is caused by plasma cells (white blood cells- the immune system) malfunctioning. At the same time, chemotherapy itself can deplete white blood cells production.
Taken together, the health, or not, of the NDMM patient’s immune system and their white blood cells, can kill the patient. This means that tracking infection is myeloma is critical for the NDMM patient. The article linked below talks about a non-invasive test to track the MM patients while blood cells.
I am a long-term MM survivor. The development of diagnostic testing for all things MM over the past 30 years has been nothing short of remarkable. A non-invasive, at-home neutrophil test is another giant step forward for diagnostic testing for the MM patient.
What diagnostic testing for multiple myeloma has been invented in the past 30 years?
- Serum Free Light Chain Assay (sFLC)
- Description: This test measures free kappa and lambda light chains in the blood, which are proteins produced by myeloma cells.
- Advancement: Provides more sensitive detection of multiple myeloma and related disorders, particularly in cases where traditional tests may not detect abnormalities.
- Imaging Techniques
- Magnetic Resonance Imaging (MRI): MRI is now extensively used to detect bone marrow involvement and soft tissue plasmacytomas. It provides detailed images of bone marrow and can identify lesions not visible on X-rays.
- Positron Emission Tomography (PET) with Computed Tomography (CT): PET-CT combines metabolic and anatomical imaging, offering a powerful tool to detect active myeloma lesions and monitor treatment response.
- Flow Cytometry
- Description: This test analyzes the physical and chemical characteristics of cells or particles in a fluid as they pass through at least one laser.
- Advancement: Allows detailed analysis of bone marrow plasma cells, identifying specific markers that differentiate malignant cells from normal ones. It’s used for both diagnosis and monitoring minimal residual disease (MRD).
- Genetic and Molecular Testing
- FISH (Fluorescence In Situ Hybridization): Detects specific genetic abnormalities in myeloma cells, providing prognostic information and guiding treatment decisions.
- Next-Generation Sequencing (NGS): Offers comprehensive genetic profiling of myeloma cells, identifying mutations and alterations that can be targeted with specific therapies.
- Minimal Residual Disease (MRD) Testing
- Description: MRD tests measure the number of myeloma cells remaining after treatment.
- Advancement: Techniques like multiparameter flow cytometry and NGS have made it possible to detect very low levels of disease, aiding in assessing treatment efficacy and predicting relapse.
- Mass Spectrometry
- Description: Used for measuring monoclonal proteins in blood or urine.
- Advancement: Provides high sensitivity and specificity, improving the accuracy of detecting and monitoring myeloma proteins compared to traditional electrophoresis methods.
Are you a newly diagnosed myeloma (NDMM) patient? If you would like to learn more about both conventional and evidence-based non-conventional MM therapies, email me at David.PeopleBeatingCancer@gmail.com
thank you,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
A new way to spot life-threatening infections in cancer patients
“Chemotherapy and other treatments that take down cancer cells can also destroy patients’ immune cells. Every year, that leads tens of thousands of cancer patients with weakened immune systems to contract infections that can turn deadly if unmanaged.
Doctors must strike a balance between giving enough chemotherapy to eradicate cancer while not giving so much that the patient’s white blood cell count gets dangerously low, a condition known as neutropenia. It can also leave patients socially isolated in between rounds of chemotherapy. Currently, the only way for doctors to monitor their patients’ white blood cells is through blood tests.
Now Leuko is developing an at-home white blood cell monitor to give doctors a more complete view of their patients’ health remotely. Rather than drawing blood, the device uses light to look through the skin at the top of the fingernail, and artificial intelligence to analyze and detect when white blood cells reach dangerously low levels…
The company has been working with the Food and Drug Administration (FDA) over the last four years to design studies confirming their device is accurate and easy to use by untrained patients. Later this year, they expect to begin a pivotal study that will be used to register for FDA approval…
“Some of the physicians that we have talked to are very excited because they think future versions of our product could be used to personalize the dose of chemotherapy given to each patient,” says Leuko co-founder and CEO Carlos Castro-Gonzalez, a former postdoc at MIT. “If a patient is not becoming neutropenic, that could be a sign that you could increase the dose. Then every treatment could be based on how each patient is individually reacting…”
Leuko’s founders knew people with cancer stood to benefit the most from a noninvasive white blood cell monitor. Unless patients go to the hospital, they can currently monitor only their temperature from home. If they show signs of a fever, they’re advised to go to the emergency room immediately.
“These infections happen quite frequently,” Sanchez-Ferro says. “One in every six cancer patients undergoing chemotherapy will develop an infection where their white blood cells are critically low. Some of those infections unfortunately end in deaths for patients, which is particularly terrible because they’re due to the treatment rather than the disease. [Infections] also mean the chemotherapy gets interrupted, which increases negative clinical outcomes for patients.”
Leuko’s optical device works through imaging the capillaries, or small blood vessels, just above the fingernail, which are more visible and already used by doctors to assess other aspects of vascular health. The company’s portable device analyzes white blood cell activity to detect critically low levels for care teams.
In a study of 44 patients in 2019, Leuko’s team showed the approach was able to detect when white blood cell levels dropped below a critical threshold, with minimal false positives. The team has since developed a product that another, larger study showed unsupervised patients can use at home to get immune information to doctors.
“We work completely noninvasively, so you can perform white blood cell measurements at home and much more frequently than what’s possible today,” Bourquard says. “The key aspect of this is it allows doctors to identify patients whose immune systems become so weak they’re at high risk of infection. If doctors have that information, they can provide preventative treatment in the form of antibiotics and growth factors. Research estimates that would eliminate 50 percent of hospitalizations…”
Leuko’s team even sees a future where their device could be used to monitor other biomarkers in the blood.
“We believe this could be a platform technology,” Castro-Gonzalez says. “We get these noninvasive videos of the blood flowing through the capillaries, so part of the vision for the company is measuring other parameters in the blood beyond white blood cells, including hemoglobin, red blood cells, and platelets. That’s all part of our roadmap for the future.”