OCT 14, 2020 5:00 PM SGT

Multiple Myeloma: Past, Present and Future

C.E. Credits: P.A.C.E. CE Florida CE
  • Assistant Professor, Cancer Biology Division, Department of Radiation Oncology, School of Medicine, Washington University in Saint Louis

      Prof. Azab earned a Pharmacy degree (2000), MSc in Medicinal Chemistry (2003) and a Ph.D. in Pharmaceutical Sciences (2007) from The Hebrew University of Jerusalem, and completed post-doctoral training focusing on biology of hematologic malignancies at Harvard Medical School/Dana-Farber Cancer Institute in 2012. Prof. Azab has co-authored over 80 peer-reviewed papers and 10 patents, and mentored over 40 Post-doctoral, PhD, MSc and Undergraduate Students.

      The research in Prof. Azab's Lab has a multidisciplinary translational approach involving cancer biology, immunotherapy, tissue engineering, and drug delivery. He has special interest in tumor biomarkers, tumor microenvironment, drug resistance, and metastasis in hematologic malignancies, particularly in Multiple Myeloma. He also focuses on development of ex vivo 3D tissue engineered cancer models for drug development and personalized medicine. Moreover, he specializes in development of drug delivery systems to improve the specificity and efficacy of cancer treatment: from nanoscale (targeted polymeric nanoparticles and liposomes) up to biodegradable-biocompatible natural and synthetic implant devices for controlled release of chemo and radiotherapy.


    Multiple myeloma (MM) is a cancer of plasma cells that is associated with low blood counts, bone and calcium disorders and infections. Despite advances in treatment in the past decade, the number of deaths associated with MM has not decreased. The pros and cons of bone marrow analysis are discussed: Cytogenetics (Next Gen. Sequencing), flow cytometry and FISH. Three markers and their interactions are used to identify MM cells by flow cytometry: CD138, the gold standard for detection, CD38 and CD45. CD138 is not a reliable marker because hypoxia leads to decreased expression and missed myeloma cells. The findings for a new model that can detect a new subset of myeloma with significant clonality using CD38 as a more specific marker for cell types other than MM cells are discussed. The definition and assessment of Minimal Residual Disease has changed the way we view therapeutic response in MM, and, with refinement, it can be a force to reform classifications, alter management paradigms, and identify those patients who may yet achieve a functional cure. There is no known way to detect circulating myeloma cells due to hypoxia. However, the new model is promising as it detected >80% of circulating cells, suggesting detecting myeloma without biopsies is possible using the right markers.

    Learning Objectives:

    • Understand the benefits and disadvantage of bone marrow analysis to diagnose Multiple Myeloma
    • Understand the role CD138 plays to improve Multiple Myeloma screening

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