Genomic-Based Diagnosis, Classification and Targeted Treatment of Multiple Myeloma
Genomic-Based Diagnosis, Classification and Targeted Treatment of Multiple Myeloma
Multiple myeloma is an incurable bone marrow cancer characterized by an abnormal expansion of
 plasma cells that secretes monoclonal immunoglobulin. Over the years, the molecular and
 genetic heterogeneity of the disease have been dissected. With the maturation of
 technologies, the time is ripe now to apply genomics to diagnose, classify, risk-stratify and
 prognosticate myeloma in the clinical setting and use this information to guide current
 treatment. The investigators hypothesize that the use of gene expression profiling as a
 single test will be more economical, efficient and accurate compared to the current standard
 panel of tests done at diagnosis. The investigators also hypothesize that the investigator
 can use predictive markers to identify prospectively patients who will respond to Velcade and
 that with more effective trebasedonatment, ability to measure depth of response beyond
 conventional complete response become important since more patients are achieving
 conventionally determined complete response. Using a cohort of patients treated on a standard
 treatment protocol based on Velcade-based induction treatment followed by consolidation and
 maintenance treatment, the investigators will study specifically the feasibility and accuracy
 of gene expression diagnostics, the predictive power of the investigators predefined
 predictive markers and the clinical utility of minimal residual disease measurement in
 myeloma. The results of the investigators study will allow us to improve the diagnosis, and
 prognostication of MM patients

 1. The investigators hypothesized that this will speed up diagnosis, provide comprehensive
 information for the classification and risk stratification of MM patients and can
 completely replace the current FISH assay and may be cheaper.

 2. The investigators hypothesized that TRAF3 deletion or mutation and MYC activation will
 identify patients that will have a significantly better response to Velcade.

 3. Modern treatment induced deeper response. More sensitive method of disease detection
 will allow us to know the fully extent of response to these treatment
Inclusion Criteria:

 -  All Patients fulfilling IMWG diagnostic criteria for myeloma

 Exclusion Criteria:

 -  Unable to take consent