Does MGIP represent the earliest stage of myeloma? | Sungjae Kim, PhD

Thanks for having me today. My name is Sungjae Kim. I'm a postdoc fellow at Broad Institute and Dana-Farber Cancer Institute in Boston. Today I'll be presenting about the MGIP.

So our team, recently, identified very low level of monoclonal protein using a highly sensitive mass spectrometry. This was, below the conventional detection level of 0.2g/l, that we use in SPEP and immunofixation. And we've we name this state as a MGIP, monoclonal gammopathy of indeterminate potential.

And after we found this, we had a key question to ask. Is MGIP just temporarily or does it, represent the earliest stage of the myeloma?

So what we did is firstly, we used a PLC cohort, which is a nationwide, cohort. We select those individuals who later developed to myeloma and matched individuals who did not, but had MGUS.

So what we found is, not surprisingly, most of them had MGUS, but 37 progressers, they had MGIP at any serum samples. And these MGIPs were either persist or increase to the MGUS level mostly. So that was an interesting thing we found.

And next we looked and into the monoclonal proteins, dynamics toward the myeloma diagnosis. And what we found was there was a very interesting, pattern we call a shifting dominance, where multiple M proteins appear and disappear. And, repeat over time.

And then we also looked at, those M protein at the MGIP level and going to the MGUS level. And we found that interesting that in processors they had higher growing potential compared to those in non processors. And also those are exclusively IgG and IgA in processors. While in non processors like 30% was IgM. So there is a differences in isotype distribution.

And next we used the single cell sequencing using the independent cohort. We found biological evidence that MGIP can be derived from clonal plasma cell or B cell population with, early malignant features.

Our findings suggest that the MGIP is not biologically trivial. I think MGIP is represent the earliest identifiable stage of the hematological malignancies. And of course, we need to further investigate whether this MGIP has, risk of progression to myeloma or any other hematologic malignancies in general population.

But I think this has very important, implications for early detection and patient monitoring and better risk stratification.

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