As mentioned earlier in this guide, there are multiple ways to test minimal residual disease. In this section, we will review the different tests available, their level of sensitivity, how to access them, and the potential future of these tests. 

Understanding the Bone Marrow Biopsy (BMB)

Before we dive in, it’s helpful to know what a bone marrow biopsy (BMB) is. If you’ve been diagnosed with active myeloma, having at least one BMB during your myeloma journey is almost certain. This procedure is key for doctors during diagnosis, but also to assess how well you’re responding to treatment and identify any changes on the type or aggressiveness of your myeloma.

Why Bone Marrow Biopsies Are Essential for MRD Testing

Myeloma cells primarily live and grow in your bone marrow, making it crucial to look directly at this tissue to find any remaining cancer cells. While blood tests are valuable, they may not detect very small numbers of myeloma cells that could be hiding in the bone marrow. 

If you’re new to the idea of a bone marrow biopsy or just want to learn more, check out our educational videos below, made with myeloma experts.

Learn More About Bone Marrow Biopsy

What Tests Are Used to Determine MRD?

Each MRD test provides unique and valuable information about your myeloma status. Rather than being interchangeable, these tests work together like pieces of a puzzle to give your healthcare team the most complete picture possible.

• Flow Cytometry examines individual cells in the bone marrow
• Next-Generation Sequencing (NGS) looks at the genetic patterns of myeloma cells
• Imaging can show where myeloma might be active throughout your body, even in places where it might be tricky to get a biopsy
• Blood-based MRD Tests are being validated to see if they could help monitor the disease between bone marrow biopsies

You can find additional resources to deepen your understanding of this section in the “Continue Your Learning” subsection later on.