Hello everybody, I am Mattia D'Agostino from the University of Torino, Italy. During this USH we produced some data about circulating tumour cells. So basically, Malzpomaloma is a disease of the bone marrow and the neoplastic plasma cells reside within the bone marrow. However, using flow cytometry, that is a sensitive technique, you can detect circulating tumour cells at diagnosis for almost, basically more than 90% of newly diagnosed Malzpomaloma patients. There were several reports indicating that patients with higher levels of CTCs may be at higher risk of progression or death. So in the Malzpomaloma field, restratification is key to predict if a patient has a good prognosis or a poor prognosis. And this restratification is the first step to move towards a more personalised treatment. So with restratification, you can basically tune your treatment intensity in our patients. Right now, the two methods to stratify patients is the Revice2 ISS that combines the prognostic factors of ISS, that is basically the tumour burden of our patients, plus some abnormalities at the chromosomal levels of the myeloma cells, so basically the genetic of the neoplastic cell. And combining this with LDH levels at baseline gives you four classes of risk at diagnosis. On the other hand, recently, our International Myeloma Society proposed a shared definition of high-risk myeloma, putting on top of that also some next-generation sequencing detected variables that may help to restratify our patients. So our work that we presented during this US tried to add the CTCs on top of the R2 and the IMWG definition of high-risk. What we found is that both the levels of circulating tumour cells at diagnosis and these two staging systems were independent predictors of progression or death in our patients. So patients with high CTCs perform in a poor way regarding the first-line treatment. And in terms of performance and on prediction, if you add CTCs to the R2 ISS and the CGS, is the IMWG criteria of high-risk, you are more powerful to predict the prognosis of your patient. So our data suggests that in the next iteration of the international staging system and of the consensus genomic staging, that is the one defined by the IMWG, we should include circulating tumour cells. Moreover, measuring circulating tumour cells is very easy, convenient for the patient because it is done on the peripheral blood and also the technique to measure it, the flow cytometry, is widely available worldwide. So I think that it is now time for CTCs to be measured also in clinical practice in all patients at diagnosis.
HealthTree • December 20, 2025