Multiple Myeloma: Studying Therapies and Sub-Clones by Drug-Response Array and Residual Sub-Clone Analysis in Bone Marrow Aspirates from Patients

Multiple Myeloma (MM) is a cancer of antibody-secreting plasma cells in the bone marrow. It can cause anemia, hypercalcemia, bone lesions and kidney failure. MM treatments gained major advancements over the years. However, MM is not cured yet, as the disease relapse in most patients with resistance to treatments. The cellular composition of MM includes heterogeneous clones and sub-clones that have different response to treatments. It is thought that resistant clones are present even before treatments and have a major role on relapse.

In this study we aim to further identify clones and sub-clones of MM patients by using multicolor flow cytometry. Moreover, evaluation of functional sensitivity to various treatments will identify resistant clones, and may suggest additional treatments. Our approach will better identify hazardous clones and their sensitivity to treatments, data that in the future, may be helpful for personalized choice of treatment.

Cells from BM aspirates are analyzed using 14-color FACS providing single-cell data and identification of clones and sub-clones. Cells are tested for drugs-sensitivity in culture with individual drugs and drug combinations. FACS analysis of treated cells reveal the resistant clones.

Our data reveals differences in the distribution of MM clones and sub-clones between patients. Importantly, it also reveals differences in the reaction of clones and cells from different patients to treatments.

Analysis of BM aspirations and their reaction to treatments, together with current clinical examination, will help doctors to choose best treatments for each patient and allow personalized treatment.