The Origin of Multiple Myeloma | Leif Bergsagel, MD | IMS 2023

Hello, my name is Leif Burgstahvel. I'm a consultant at the Mayo Clinic in Arizona and a researcher in multiple myeloma. I'm here at the International Loyola Society meeting in Athens, Greece. And this morning's session was about the origin of multiple myeloma. And what we're talking about there really is the cell of origin. We think multiple myeloma, the very first cell, probably got a mutation 20, 30, maybe even 40 years before the disease actually caused symptoms. And we're using advanced genetics techniques to see what can we learn about this cell that gave rise to multiple myeloma. And what we learned is there was a surprise for us that there were additional mutations caused by some unknown mechanisms that preceded the development of multiple myeloma. Again, something 20, 30, 40 years before the disease actually presented. And that was perhaps one of the, that was the first and most exciting talk in that session. And then there were two more talks in that session that talk about the stem cell. What they're talking about there is the cell which can replicate and reproduce multiple myeloma. And there's been a lot of controversy about these cells. We think that most of the cells in multiple myeloma are unable to keep growing. And that there's really only a small fraction of the cells that can reproduce the tumor. And we call those, that small fraction, we call them the stem cells. And we think what's really important about those cells is that when we treat patients and we get a complete response and we get MRD negativity and we can't detect any myeloma in the tumor, we know that these stem cells are somewhere in the patient's body. And that they're the cells that eventually cause the disease to relapse five, 10, even 15 years later. And so by trying to understand more about them, I think we can find ways to eradicate them. And that's what we heard from two different speakers about different characteristics of these stem cells. And I think our goal now that we can find them and measure them is trying to find ways to eradicate them. And that's going to be our goal for the future. Anyways, I'd like to thank you for having spent some time listening to me. I hope you're getting as much out of this meeting as I am.