A major European study has confirmed that circulating tumour cells (CTCs) are a powerful independent prognostic marker in newly diagnosed multiple myeloma (NDMM), potentially paving the way for more personalised treatment strategies. The research was presented by Luca Bertamini and honoured with one of the Best Young EHA Abstract Awards at the European Hematology Association (EHA) 2025 Congress.
The pooled analysis included patient-level data from 2,446 NDMM patients across five European research groups. All patients underwent CTC measurement before treatment, with results analysed using flow cytometry. Patients were treated either in clinical trials (59%) or routine practice (41%).
CTC levels were shown to stratify patients into five distinct prognostic groups, with progression-free survival (PFS) ranging from 77 months for the lowest CTC levels (≤0.001%) to just 16 months for the highest (≥1%). Notably, the highest-risk group resembled patients with primary plasma cell leukaemia, an aggressive form of the disease.
Importantly, the prognostic value of CTCs held independently of other risk factors such as cytogenetics, treatment regimen, or transplant eligibility. Patients with standard-risk cytogenetics but high CTCs had outcomes similar to those with high-risk genetic profiles but low CTCs.
The study suggests that CTC levels, particularly within the 0.01–0.1% range, can be used to reliably categorise patients into low- and high-risk groups. A 1% threshold could further identify a subset (9%) of ultra-high-risk patients, highlighting the potential of CTCs to guide future risk-adapted therapeutic decisions in MM.
Helena Bradbury, EMJ
Reference
Bertamini L et al. Abstract S199. EHA;12-15 June 2025, Milan, Italy.
