Blood-based MRD testing is still in the early stages of adoption in community oncology settings due to limited availability and evolving validation. Most likely, it will be used in accompaniment with bone marrow biopsy-based testing for a clearer picture of the person’s myeloma response status. 

How It Works

Blood-based MRD testing, also known as a liquid biopsy, detects cancer-related genetic material (DNA/RNA) or abnormal proteins released by myeloma cells into the bloodstream. This approach allows for monitoring disease progression without requiring as many bone marrow biopsies.

Sensitivity

Currently, blood-based MRD tests are less sensitive than bone marrow-based methods, but advancements in technology are steadily improving their detection capabilities.

Pros

• Minimally invasive: Requires only a blood draw, making it easier (and potentially safer) than bone marrow biopsies
• Easier to repeat: Enables more frequent monitoring of disease progression over time
• Potential for broader use: Ideal for patients with non-secretory or oligo-secretory myeloma who produce fewer detectable proteins

Cons

• Lower sensitivity: May miss very small amounts of residual disease compared to bone marrow tests
• Limited availability: Not yet widely accessible in clinical practice or fully validated for standard care

Researchers are still figuring out how and when it’s best to perform a blood-based MRD test to complement the information of bone marrow MRD testing. Continue reading in The Future of MRD Testing.