Circulating tumor plasma cells quantification in newly diagnosed transplant ineligible real world multiple myeloma patients: Comparison of single-platform flow cytometry versus next generation flow.

Authors

Elona Saraci, Alessandra Larocca, Roberto Ria, Silvia Mangiacavalli, Giulia Benevolo, Nicola Giuliani, Renato Zambello, Angelo Belotti, Ilaria Rizzello, Antonietta Pia Falcone, Iolanda Donatella Vincelli, Mariagrazia Michieli, Sonia Ronconi, Patrizia Tosi, Maria Letizia Mosca Siez, Alessandro Allegra, Maide Maria Cavalli, Matilde Scaldaferri, Ilaria Fedele, Marco Burdisso, Tania Villanova, Cristina Velluti, Marcello Capriata, Donato Mannina, Anna Maria Cafro, Elisabetta Antonioli, Sonia Morè, Mario Boccadoro, Benedetto Bruno, Sara Bringhen, Mattia D'Agostino

Published in

Cytometry. Part B, Clinical cytometry. Sep 14, 2026. Epub Sep 14, 2026.

Abstract

Circulating tumor plasma cells (CTCs) at diagnosis are independent prognostic markers in newly diagnosed multiple myeloma (NDMM). Flow cytometry (FC) enables sensitive and cost-effective CTC quantification, but prognostic cut-offs vary across studies. The methodological approach used for quantification may affect the determination of the CTC percentage. In this study we compare head-to-head two FC techniques [single-platform FC versus Next Generation Flow (NGF)] to measure CTC levels in NDMM patients. Methodological differences between the two techniques can be found in sample processing (NGF includes fixation and permeabilization steps that are not required for CTC quantification by single-platform FC) and analytical sensitivity, which is higher for NGF than for single-platform FC. The percentage of CTCs was simultaneously assessed with both techniques in the peripheral blood (PB) of 34 patients enrolled in the REAL MM trial (NCT03829371) at screening. Single-platform FC detected CTCs in 29/34 patients (85.3%) patients, while NGF detected CTCs in 31/34 patients (91.2%), including 2 cases that were negative by single-platform FC. The CTC percentage measured using the NGF technique (median 0.0049%, range 0%-0.377%) was significantly lower than that obtained using single-platform FC (median 0.009%, range 0%-0.59%) (p < 0.0001). Indeed, quantifying CTCs with FC after fixation and permeabilization (comparably to NGF) led to results that were similar to NGF. In conclusion, NGF demonstrated higher sensitivity than single-platform FC to detect CTCs at diagnosis in MM patients. Employing standardized techniques like NGF may avoid variability across different laboratories and centers.

PMID:
42740309
Bibliographic data and abstract were imported from PubMed on 15 Sep 2026.

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