CAN CAPILLARY ZONE ELECTROPHORESIS MONITOR DARWINIAN EVOLUTION OF MULTIPLE MYELOMA CLONES?
(Abstract release date: 05/19/16)
EHA Library. Kotoucek P. 06/09/16; 132835; E1286
Disclosure(s): N/A
Dr. Pavel Kotoucek
Contributions
Contributions
Abstract
Abstract: E1286
Type: Eposter Presentation
Background
At the time of diagnosis of multiple myeloma (MM) and similar disorders there are multiple clones in bone marrow or in extramedullary sites. Usually only a dominant clone is diagnosed and monitored in daily clinical practice before, during or after chemotherapy. Non dominant clones are not measured routinely nor their evolution under pressure of chemotherapy.We present identification and monitoring of multiple clones of multiple myeloma and similar disorders by capillary zone electrophoresis (CZE) in routine clinical settings and evolution of these clones during a 5 year follow up and during third line chemotherapy by lenalidomide
Aims
Multiple myeloma is heterogenous disease with multiple clones. There is no techique available in routine clinical practice to monitor dominant and non-dominant clones in the same time. Chemotherapy bears a risk of supressing less aggressive dominant clone and enhancing evolution process of very aggressive and chemotherapy resistant clones. Our aim was to monitor all clones simultaneously during natural course of disease and during chemotherapy to understand evolution process in routine practice.
Methods
1/CZE results captured from 1.1.2009 till 31.12.2009 in a single hospital pathology centre with a 5 year follow up correlated with clinical outcomes of patients.2/Results of patients with mutliple myeloma on third line chemotherapy with lenalidomide in single centre from 1.1.2010 till 31.12.2015 monitored by CZE
Results
1/ All consecutive patients with any paraprotein visible in CZE within year 2009 in our centre: N=314. Break down these patients to a number of all patients with only one paraprotein on CZE is n= 277, a number of patients with two or three paraproteins is n= 37.Evolution of clones within one year (2009): from one paraprotein to two visible in CZE was in n=8 patients. One patient has experienced evolution from one clone to thee clones within one year. 5 year follow up data of all patients with more than 1 paraprotein are available only in 11 patients from original 37 patients.Their diagnoses were: MGUS n=2 with further increasing number of clones from 2 to 3 within 5 years; CLL n= 2, one patient with increasing number of paraproteins from 2 to 3, Waldenstroam Macroglobulinaemia n= 3, one patient with increasing number of paraproteins from 2 to 3.2/ Patients on third line chemotherapy n=56 based on lenalidomide were monitored by CZE. Evolution of multiple clones is demonstrated by CZE
Conclusion
CZE is a very sensitive and unique method capable capturing even non-dominant minor clones and monitoring them during observation or chemotherapy and to assess response to chemotherapy in a deeper level in routine practice. CZE can describe selection of clones during chemotherapy.A high sensitivity of CZE can reveal paraprotein in patients with lymphopoliferative disorders.For better understanding of CZE in monitoring of non-dominant clones further correlation with flowcytometry and even with cytogenetic and genomic assays are needed.
Session topic: E-poster
Keyword(s): Clonality, Myeloma
Type: Eposter Presentation
Background
At the time of diagnosis of multiple myeloma (MM) and similar disorders there are multiple clones in bone marrow or in extramedullary sites. Usually only a dominant clone is diagnosed and monitored in daily clinical practice before, during or after chemotherapy. Non dominant clones are not measured routinely nor their evolution under pressure of chemotherapy.We present identification and monitoring of multiple clones of multiple myeloma and similar disorders by capillary zone electrophoresis (CZE) in routine clinical settings and evolution of these clones during a 5 year follow up and during third line chemotherapy by lenalidomide
Aims
Multiple myeloma is heterogenous disease with multiple clones. There is no techique available in routine clinical practice to monitor dominant and non-dominant clones in the same time. Chemotherapy bears a risk of supressing less aggressive dominant clone and enhancing evolution process of very aggressive and chemotherapy resistant clones. Our aim was to monitor all clones simultaneously during natural course of disease and during chemotherapy to understand evolution process in routine practice.
Methods
1/CZE results captured from 1.1.2009 till 31.12.2009 in a single hospital pathology centre with a 5 year follow up correlated with clinical outcomes of patients.2/Results of patients with mutliple myeloma on third line chemotherapy with lenalidomide in single centre from 1.1.2010 till 31.12.2015 monitored by CZE
Results
1/ All consecutive patients with any paraprotein visible in CZE within year 2009 in our centre: N=314. Break down these patients to a number of all patients with only one paraprotein on CZE is n= 277, a number of patients with two or three paraproteins is n= 37.Evolution of clones within one year (2009): from one paraprotein to two visible in CZE was in n=8 patients. One patient has experienced evolution from one clone to thee clones within one year. 5 year follow up data of all patients with more than 1 paraprotein are available only in 11 patients from original 37 patients.Their diagnoses were: MGUS n=2 with further increasing number of clones from 2 to 3 within 5 years; CLL n= 2, one patient with increasing number of paraproteins from 2 to 3, Waldenstroam Macroglobulinaemia n= 3, one patient with increasing number of paraproteins from 2 to 3.2/ Patients on third line chemotherapy n=56 based on lenalidomide were monitored by CZE. Evolution of multiple clones is demonstrated by CZE
Conclusion
CZE is a very sensitive and unique method capable capturing even non-dominant minor clones and monitoring them during observation or chemotherapy and to assess response to chemotherapy in a deeper level in routine practice. CZE can describe selection of clones during chemotherapy.A high sensitivity of CZE can reveal paraprotein in patients with lymphopoliferative disorders.For better understanding of CZE in monitoring of non-dominant clones further correlation with flowcytometry and even with cytogenetic and genomic assays are needed.
Session topic: E-poster
Keyword(s): Clonality, Myeloma
Abstract: E1286
Type: Eposter Presentation
Background
At the time of diagnosis of multiple myeloma (MM) and similar disorders there are multiple clones in bone marrow or in extramedullary sites. Usually only a dominant clone is diagnosed and monitored in daily clinical practice before, during or after chemotherapy. Non dominant clones are not measured routinely nor their evolution under pressure of chemotherapy.We present identification and monitoring of multiple clones of multiple myeloma and similar disorders by capillary zone electrophoresis (CZE) in routine clinical settings and evolution of these clones during a 5 year follow up and during third line chemotherapy by lenalidomide
Aims
Multiple myeloma is heterogenous disease with multiple clones. There is no techique available in routine clinical practice to monitor dominant and non-dominant clones in the same time. Chemotherapy bears a risk of supressing less aggressive dominant clone and enhancing evolution process of very aggressive and chemotherapy resistant clones. Our aim was to monitor all clones simultaneously during natural course of disease and during chemotherapy to understand evolution process in routine practice.
Methods
1/CZE results captured from 1.1.2009 till 31.12.2009 in a single hospital pathology centre with a 5 year follow up correlated with clinical outcomes of patients.2/Results of patients with mutliple myeloma on third line chemotherapy with lenalidomide in single centre from 1.1.2010 till 31.12.2015 monitored by CZE
Results
1/ All consecutive patients with any paraprotein visible in CZE within year 2009 in our centre: N=314. Break down these patients to a number of all patients with only one paraprotein on CZE is n= 277, a number of patients with two or three paraproteins is n= 37.Evolution of clones within one year (2009): from one paraprotein to two visible in CZE was in n=8 patients. One patient has experienced evolution from one clone to thee clones within one year. 5 year follow up data of all patients with more than 1 paraprotein are available only in 11 patients from original 37 patients.Their diagnoses were: MGUS n=2 with further increasing number of clones from 2 to 3 within 5 years; CLL n= 2, one patient with increasing number of paraproteins from 2 to 3, Waldenstroam Macroglobulinaemia n= 3, one patient with increasing number of paraproteins from 2 to 3.2/ Patients on third line chemotherapy n=56 based on lenalidomide were monitored by CZE. Evolution of multiple clones is demonstrated by CZE
Conclusion
CZE is a very sensitive and unique method capable capturing even non-dominant minor clones and monitoring them during observation or chemotherapy and to assess response to chemotherapy in a deeper level in routine practice. CZE can describe selection of clones during chemotherapy.A high sensitivity of CZE can reveal paraprotein in patients with lymphopoliferative disorders.For better understanding of CZE in monitoring of non-dominant clones further correlation with flowcytometry and even with cytogenetic and genomic assays are needed.
Session topic: E-poster
Keyword(s): Clonality, Myeloma
Type: Eposter Presentation
Background
At the time of diagnosis of multiple myeloma (MM) and similar disorders there are multiple clones in bone marrow or in extramedullary sites. Usually only a dominant clone is diagnosed and monitored in daily clinical practice before, during or after chemotherapy. Non dominant clones are not measured routinely nor their evolution under pressure of chemotherapy.We present identification and monitoring of multiple clones of multiple myeloma and similar disorders by capillary zone electrophoresis (CZE) in routine clinical settings and evolution of these clones during a 5 year follow up and during third line chemotherapy by lenalidomide
Aims
Multiple myeloma is heterogenous disease with multiple clones. There is no techique available in routine clinical practice to monitor dominant and non-dominant clones in the same time. Chemotherapy bears a risk of supressing less aggressive dominant clone and enhancing evolution process of very aggressive and chemotherapy resistant clones. Our aim was to monitor all clones simultaneously during natural course of disease and during chemotherapy to understand evolution process in routine practice.
Methods
1/CZE results captured from 1.1.2009 till 31.12.2009 in a single hospital pathology centre with a 5 year follow up correlated with clinical outcomes of patients.2/Results of patients with mutliple myeloma on third line chemotherapy with lenalidomide in single centre from 1.1.2010 till 31.12.2015 monitored by CZE
Results
1/ All consecutive patients with any paraprotein visible in CZE within year 2009 in our centre: N=314. Break down these patients to a number of all patients with only one paraprotein on CZE is n= 277, a number of patients with two or three paraproteins is n= 37.Evolution of clones within one year (2009): from one paraprotein to two visible in CZE was in n=8 patients. One patient has experienced evolution from one clone to thee clones within one year. 5 year follow up data of all patients with more than 1 paraprotein are available only in 11 patients from original 37 patients.Their diagnoses were: MGUS n=2 with further increasing number of clones from 2 to 3 within 5 years; CLL n= 2, one patient with increasing number of paraproteins from 2 to 3, Waldenstroam Macroglobulinaemia n= 3, one patient with increasing number of paraproteins from 2 to 3.2/ Patients on third line chemotherapy n=56 based on lenalidomide were monitored by CZE. Evolution of multiple clones is demonstrated by CZE
Conclusion
CZE is a very sensitive and unique method capable capturing even non-dominant minor clones and monitoring them during observation or chemotherapy and to assess response to chemotherapy in a deeper level in routine practice. CZE can describe selection of clones during chemotherapy.A high sensitivity of CZE can reveal paraprotein in patients with lymphopoliferative disorders.For better understanding of CZE in monitoring of non-dominant clones further correlation with flowcytometry and even with cytogenetic and genomic assays are needed.
Session topic: E-poster
Keyword(s): Clonality, Myeloma
{{ help_message }}
{{filter}}