Germline predisposition in multiple myeloma.

We present a study of rare germline predisposition variants in 954 unrelated individuals with multiple myeloma (MM) and 82 MM families. Using a candidate gene approach, we identified such variants across all age groups in 9.1% of sporadic and 18% of familial cases.

Distinguishing Daratumumab from Endogenous Monoclonal Proteins in Serum from Multiple Myeloma Patients Using an Automated Mass Spectrometry System.

Background: Therapeutic monoclonal antibodies (t-mAbs) may interfere with electrophoresis-based methods used to monitor multiple myeloma (MM), which can create inaccurate results. Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry is an alternative to gels distinguishing between endogenous M-proteins and t-mAbs based on molecular mass.

Methods: Serum samples (n = 109) from 34 MM patients receiving Dara-KRd were collected 14 or 28 days postdaratumumab administration.

Rapid high-dose cyclophosphamide as bridging treatment for advanced therapies in multiple myeloma.

Patients with relapsed/refractory multiple myeloma proceeding with chimeric antigen receptor (CAR) T-cell therapy or bispecific antibodies (BsAb) may need bridging therapy to realize their benefits. We evaluated the efficacy and safety of rapid, peripheral, high-dose cyclophosphamide (TurboCy) in 15 patients intending to proceed with CAR T-cell therapy, BsAbs, or long-term regimens. The overall response rate was 80% and the clinical benefit rate was 100% in a heavily pretreated high-risk cohort.

Discontinuation of maintenance therapy in multiple myeloma guided by multimodal measurable residual disease negativity (MRD2STOP).

MRD2STOP is a pragmatic trial evaluating maintenance therapy cessation guided by measurable residual disease (MRD) negativity in multiple myeloma (MM). Eligible patients had previous MRD < 10, received ≥1 year of maintenance, and were prospectively confirmed to have undetectable disease by positron emission tomography, bone marrow (BM) flow cytometry (limit of detection [LoD] 10), and BM clonoSEQ (LoD 10). BM aspirates enriched for CD138 cells were analyzed by clonoSEQ to achieve MRD 10 sensitivity.