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The primary treatment option for younger Multiple Myeloma (MM) patients is a hematopoietic stem cell transplant (HSCT), and although this is now a routine process, it still involves the invasive process of bone marrow (BM) biopsies. Such biopsies are used to monitor the success of transplant in terms of engraftment, but this is painful for patients and carries a high risk of infection. This poses a challenge to the task of investigating and following the engraftment process, but recent developments in imaging modalities could circumvent this.
Kirsten M. Williams, from the Children’s Research Institute, Children’s National Health System, Washington, USA, and colleagues, carried out a pilot study in which they investigated the use of 18F-fluorothymidine (¹⁸F-FLT) imaging during HSCT to visualize early cellular proliferation and subsequent engraftment. The results of the study were published in the Lancet Haematology in January 2018.
This study showed that the characterization and quantification of subclinical HSC homing and repopulation after HSCT were possible with the use of the radiolabeled tracer ¹⁸F-FLT. The tracer also detected early hematopoietic cell proliferation in the BM and revealed an association between the intensity of ¹⁸F-FLT uptake and the pace of engraftment. Given that ¹⁸F-FLT was well-tolerated with no associated adverse events, the authors suggest the potential use of ¹⁸F-FLT as a biomarker of hemopoiesis, and this could potentially replace BM biopsies to test for transplant success.
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