Buenache Natalia, Sánchez-delaCruz Andrea, Cuenca Isabel, Giménez Alicia, Moreno Laura, Martínez-López Joaquín, Rosa-Rosa Juan Manuel
Department of Translational Haematology, Research Institute Hospital 12 de Octubre (i+12) Haematological Tumors Clinical Research Unit H12O-CNIO, 28041 Madrid, Spain.
Department of Translational Haematology, Haematology Service, Hospital 12 de Octubre, 28041 Madrid, Spain.
Cancers (Basel). 2023 May 25;15(11):2911. doi: 10.3390/cancers15112911.
Multiple myeloma (MM) is a hematological malignancy characterized by the clonal proliferation of pathogenic CD138+ plasma cells (PPCs) in bone marrow (BM). Recent years have seen a significant increase in the treatment options for MM; however, most patients who achieve complete the response ultimately relapse. The earlier detection of tumor-related clonal DNA would thus be very beneficial for patients with MM and would enable timely therapeutic interventions to improve outcomes. Liquid biopsy of "cell-free DNA" (cfDNA) as a minimally invasive approach might be more effective than BM aspiration not only for the diagnosis but also for the detection of early recurrence. Most studies thus far have addressed the comparative quantification of patient-specific biomarkers in cfDNA with PPCs and BM samples, which have shown good correlations. However, there are limitations to this approach, such as the difficulty in obtaining enough circulating free tumor DNA to achieve sufficient sensitivity for the assessment of minimal residual disease. Herein, we summarize current data on methodologies to characterize MM, and we present evidence that targeted capture hybridization DNA sequencing (tchDNA-Seq) can provide robust biomarkers in cfDNA, including immunoglobulin (IG) rearrangements. We also show that detection can be improved by prior purification of the cfDNA. Overall, liquid biopsies of cfDNA to monitor IG rearrangements have the potential to provide important diagnostic, prognostic, and predictive information in patients with MM.
多发性骨髓瘤(MM)是一种血液系统恶性肿瘤,其特征是骨髓(BM)中致病性CD138 +浆细胞(PPC)的克隆性增殖。近年来,MM的治疗选择显著增加;然而,大多数达到完全缓解的患者最终都会复发。因此,早期检测肿瘤相关的克隆DNA对MM患者非常有益,并能及时进行治疗干预以改善预后。作为一种微创方法的“游离DNA”(cfDNA)液体活检不仅在诊断方面,而且在早期复发检测方面可能比骨髓穿刺更有效。迄今为止,大多数研究都涉及cfDNA中患者特异性生物标志物与PPC和BM样本的比较定量,结果显示出良好的相关性。然而,这种方法存在局限性,例如难以获得足够的循环游离肿瘤DNA以实现对微小残留病评估的足够灵敏度。在此,我们总结了目前关于MM特征化方法的数据,并提供证据表明靶向捕获杂交DNA测序(tchDNA-Seq)可以在cfDNA中提供强大的生物标志物,包括免疫球蛋白(IG)重排。我们还表明,通过cfDNA的预先纯化可以提高检测效果。总体而言,对cfDNA进行液体活检以监测IG重排有可能为MM患者提供重要的诊断、预后和预测信息。