Chip-based “liquid biopsy” blood test for multiple myeloma under development

A new test may allow patients to avoid unnecessary bone biopsies

Researchers from the University of Kansas have developed a new testing system based on a small plastic “chip” for testing for multiple myeloma. Currently the diagnosis of multiple myeloma is based on firstly finding a monoclonal band on serum protein electrophoresis. A monoclonal band is an abnormal finding due to the proliferation of an abnormal and potentially cancerous group of antibody-producing cells in the patient’s bone marrow.
If a person is found to have a monoclonal band then this will be followed up with a bone marrow biopsy which will be examined under the microscope by a pathologist to detect multiple myeloma tumour cells. The bone marrow biopsy is quite an invasive process since the doctor must get a sample of bone marrow from within a bone in the patient’s body. This is most commonly done by punching a large-bore needle into the person’s sternum in the middle of their chest.
The aim of the Kansas researchers is to develop their test to a stage where it can replace the bone marrow biopsy with a simple blood test. This new testing system is another example of the “liquid biopsy” tests that we have discussed previously on the Lab Tests Online website. In this case the researchers are using microfluidics techniques to process a sample of whole blood from the patient and to extract any multiple myeloma tumour cells that are present in the blood in affected people.
The results of the preliminary testing that the researchers have done so far show that these cells are absent in healthy subjects but are present in all people who have been diagnosed with multiple myeloma. They are also present in lesser numbers in the majority of people who have been diagnosed with “monoclonal gammopathy of undetermined significance” which is a condition where the person has the monoclonal protein in their blood but the bone marrow biopsy is not diagnostic of multiple myeloma.  
If these results can be confirmed with further large-scale testing this new test could save many patients from having bone marrow biopsies.
Further reading:
University of Kansas news
Scientific abstract

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