At a crossroads: circulating tumor cells in myeloma

In this issue of Blood, Fokkema et al 1 have identified 3 factors that determine high levels of circulating plasma cells in the peripheral blood in multiple myeloma (MM): a high tumor burden in the bone marrow, the MAF primary genetic subgroup, and TP53/+1q/APOBEC high-risk mutations.As evidence accumulates suggesting that circulating tumor cells (CTCs) are a robust tool for clinical risk assessment in newly diagnosed multiple myeloma (NDMM), this study clarifies the relationship between CTCs and their associated tumor-intrinsic features.