Introduction

Minimal residual disease (MRD) negativity is a critical prognostic factor in multiple myeloma (MM), but conventional monitoring relies on invasive bone marrow (BM) testing and may miss disease due to spatial heterogeneity. EasyM is a mass spectrometry-based blood assay that tracks patient-specific M-protein peptides in peripheral blood, enabling frequent, non-invasive MRD monitoring. Its role in combination with established MRD methods has not been fully defined.

Study Summary

This study evaluated 91 newly diagnosed, transplant-eligible MM patients across Canada, monitored longitudinally from diagnosis through maintenance therapy. EasyM results from peripheral blood were compared with BM next-generation sequencing (NGS, 10⁻⁵ and 10⁻⁶ sensitivity), multiparameter flow cytometry (MFC), and 18F-FDG PET/CT imaging. Samples were collected at key treatment milestones: post-induction chemotherapy, 100 days post-transplant, after 12 months of maintenance therapy, and every six months thereafter, with a median follow-up of 920 days.

Key Findings

  • MRD negativity rates: EasyM 18%, NGS 10⁻⁶ 21%, NGS 10⁻⁵ 57%, MFC 58%, PET 83%

  • Highest concordance observed between EasyM and NGS 10⁻⁶

  • Strong correlation of EasyM with NGS, MFC, and serum protein electrophoresis (Spearman r ≥ 0.8, p < 0.01)

  • No patient achieving MRD negativity by EasyM has relapsed to date

  • EasyM detected rising M-protein 2-12 months before clinical relapse in most progressing patients

  • Combining EasyM with NGS 10⁻⁶ provided strongest relapse prediction (AUC 0.84 at 1 year; 0.80 at 2 years)

Conclusions

EasyM is a sensitive, non-invasive tool for frequent MRD monitoring in MM. When integrated with established assays, it improves relapse prediction, supports response-adapted treatment strategies, and reduces reliance on invasive bone marrow testing, offering a valuable approach for both clinical practice and trial design.

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Authors

Aimee A. Wong, Dor D. Abelman, Zac McDonald, Bin Ma, Liqiang Yang, Abir Khaled, Sarah Bridges, Darrell White, Christopher P. Venner, Richard LeBlanc, Francois Benard, Donna Reece, Irwindeep Sandhu, Kevin Song, Michael Sebag, Nizar Bahlis, Hira Mian, Suzanne Trudel, Trevor J. Pugh, Anthony Reiman

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