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Diagnostic tests, such as fluorescence in situ hybridization (FISH) and cytogenetics, help to identify individuals who have moved from smoldering myeloma to active multiple myeloma. According to Sundar Jagannath, MD, in this era of genomic medicine, gene expression profiling may play a role in defining myeloma and assessing risk of the disease, as it provides more information than FISH and cytogenetics.
Currently, gene expression profiling is only used prognostically and does not help guide management of the high-risk patient, notes Jagannath. Jeffrey A. Zonder, MD, and Sagar Lonial, MD, agree that although gene expression profiling offers more information, it is not ready to be used in standard practice.
James R. Berenson, MD, explains that he and colleagues have identified a new solubilized receptor, known as B-cell maturation antigen (BCMA), which has been shown to be highly prognostic; it also may be used to monitor multiple myeloma in the future.