Assessing Glutamine Metabolism in MGUS and Myeloma

  • STATUS
    Recruiting
  • End date
    Jun 30, 2024
  • participants needed
    100
  • sponsor
    Mayo Clinic
Updated on 25 March 2022
measurable disease
bone marrow procedure
immunoglobulins
bone marrow plasma cells

Summary

The utilization of glutamine by the bone marrow plasma cells in MGUS and MM will be compared between each other after infusion of 13-carbon labelled glutamine.

Description

Multiple myeloma (MM) is always preceded by a pre-malignant asymptomatic phase, monoclonal gammopathy of undetermined significance (MGUS). Given the incurable nature of MM it is vital to study the development of MM from MGUS to help in identifying early diagnostic and treatment opportunities. This project aims to determine if glutamine metabolism in plasma cells is vital for their survival and whether it is associated with the progression of MGUS to MM. It will involve the utilization of stable isotope resolved metabolomics methods to evaluate the utilization of glutamine by the bone marrow plasma cells in MGUS compared to MM. Patients with MGUS and MM will undergo bone marrow aspirations after being infused with 13-carbon labelled glutamine. The subsequent bone marrow plasma cells obtained from these aspirates will undergo GC-MS assessments of the TCA cycle isotopomers. This will help determine the differences in the utilization of glutamine by the bone marrow plasma cells between MGUS and MM.

Details
Condition Myeloma, MGUS
Treatment Infusion of 13-Carbon labeled Glutamine
Clinical Study IdentifierNCT03119883
SponsorMayo Clinic
Last Modified on25 March 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

IMWG criteria for the diagnosis of either MGUS or MM5
Presence of measurable disease defined by an M-spike of >1 g/dL and/or involved serum free immunoglobulin light chain >10 mg/dL
For MGUS cohort only
At least 5 to <10% cPCs in the prior BM aspirate
Not received any plasma cell directed therapy
For MM cohort
At least >10% cPCs in recent BM aspirate
Newly diagnosed MM without receiving any plasma cell directed therapy OR Relapsed MM without having received salvage chemotherapy

Exclusion Criteria

For both MGUS and MM cohorts
Unable to provide consent
ECOG PS >1
Hemoglobin <10 g/dL
GFR <50 ml/min
Women who are pregnant
Abnormal liver function tests
Abnormal bleeding history or coagulation profile (INR >1.5)
Prior history of adverse events with conscious sedation
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