Survival of patients with blood cancers has increased recently due to bone marrow transplantation. Bone marrow transplantation is a therapeutic technique that uses hematopoietic stem cells to treat those cancers. Hematopoietic stem cells are the cells that give rise to all blood cells. In additional to the hematopoietic stem cells the bone marrow also contains mesenchymal stem cells (cells that give rise to fat cells and bone cells).

The improvement in survival came at the cost of increasing morbidity in patients; like increased risk of bone fractures, and metabolic syndrome (obesity, dyslipidemia and diabetes…). To-date, the phenotypic and morphologic changes in  mesenchymal stem cells, and their impact on the clinical phenotype,  in patients undergoing bone marrow transplantation has not been studied significantly. In this study, we want to establish a novel 3D silk culture model that mimics the bone marrow environment in the lab and use it to investigate mesenchymal cells differentiation and interaction with myeloma cells (cancerous white blood cells). We will also use this model to test our hypothesis that post autologous stem cell transplant the mesenchymal cells differentiate into fat cells more than bone forming cells contributing both to morbidities and tumor growth. We will then also investigate the sensitivity of the myeloma cells to different drugs in the lab, identify regulatory molecules, and try to correlate them with the bone and fat changes observed in patients.

We will take part (3-4ml) of the bone marrow aspirate samples and (20 ml) of peripheral blood samples collected as part of standard medical practice before and after transplantation.

Bone marrow aspirates will be sampled at diagnosis, before bone marrow transplantation, at 1 month, and 3 months post transplantation while peripheral blood will be withdrawn at diagnosis  pre-transplant, at 3, 6, and 12 months post-transplant. Patient will undergo nutritional assessment pre-transplant at 3, 6 and 12 months post-transplant. Patient will also undergo body composition analysis, bone density, and visceral fat assessment pre-transplant, at 3 and 12 months post-transplant. They will also undergo nutritional assessment pre-transplant at 3 months, 6 months and 12 months post-transplant.

All the patients interested in participating in the study will be asked to sign an informed consent form 

Adult patients diagnosed with multiple myeloma undergoing autologous stem cell transplantation at AUBMC

Patients will be informed by their treating physician about the study privately in the clinic, if patient is interested he/she will be asked to sign the consent.