Scientists Find Proof of How Myeloma Develops

Investigators in the West Midlands have made a breakthrough in describing how an incurable kind of blood cancer, Myeloma, results from a usually symptomless prior blood disorder. The results could guide to more effective therapies and ways to determine those most at risk of developing the cancer.

All individuals diagnosed with myeloma, a cancer of the blood-producing bone marrow, initially develop a relatively harmless condition known as ‘monoclonal gammopathy of undetermined significance’ or ‘MGUS’.

MGUS is quite common in the older people and only advances to cancer in roughly 1% of cases. However, presently there is no way of accurately forecasting which individuals with MGUS are probably to go on to get myeloma.

Myeloma is diagnosed in about 4,000 individuals each year in the UK. It particularly impacts antibody-producing white blood cells identified in the bone marrow, known as plasma cells. The investigator team from the University of Birmingham, New Cross and Heartlands Hospitals compared the cellular chemistry of bone marrow and blood samples obtained from sufferers with myeloma, sufferers with MGUS and healthy volunteers.

Interestingly, the investigators identified that the metabolic activity of the bone marrow of sufferers with MGUS was considerably different to plasma from healthy subjects, but there were very few variations at all between the MGUS and myeloma samples. The study was financed by the blood cancer charity Bloodwise, which changed its name from Leukaemia & Lymphoma in September.

Metabolism is the chemical process via which cells create strength and the substances required to grow and execute cell functions. Cancer cells promote metabolic modifications to kick start and generate their rapid development.

The results, published in Blood Cancer Journal, recommend that the biggest metabolic modifications occur with the progression of the symptomless situation MGUS and not with the later progression to myeloma.

Dr Daniel Tennant, who lead the study at the University of Birmingham, stated, “Our results show that very few modifications are needed for a MGUS sufferer to progress to myeloma as we now know almost all sufferers with myeloma develop from MGUS. A drug that intervenes with these particular initial metabolic modifications could make a very effective therapy for myeloma, so this is a very interesting discovery.”

The study team identified over 200 products of metabolism that differed between the healthy subjects and individuals with MGUS or myeloma, compared to just 26 variations between MGUS patients and myeloma affected individuals. The investigators think that these small modifications could drive the key changes in the bone marrow needed to support myeloma development.

Head of Research at Bloodwise, Dr. Matt Kaiser, stated, “Myeloma is a harmful cancer that can lead to devastating and painful bone damage and, even though we have become much better at dealing with it and increasing the lives of myeloma sufferers, it is eventually almost always fatal. This study offers the basis for developing new and more focused therapies and minimally invasive ways of figuring out those MGUS sufferers at risk of advancing to myeloma. If we can discover ways to block the development of MGUS, we hope to prevent many cases of myeloma in the future.”