With the advent of novel, highly effective therapies for multiple myeloma (MM), classical serologic monitoring appears insufficient for response assessment and prediction of relapse. Moreover, serologic studies in MM are hampered by interference of therapeutic antibodies. The detection of malignant plasma cell clones by next generation sequencing (NGS) or multiparameter flow cytometry (MFC) circumvents these difficulties and can be performed in the peripheral blood (pB) by targeting circulating cell-free DNA (cfDNA) or circulating plasma cells (CPCs), thus also avoiding an invasive sampling procedure. Here, we applied NGS of VJ light chain (LC) rearrangements in cfDNA and MFC of magnetically-enriched CD138-positive CPCs (me-MFC) to investigate disease burden in unselected MM patients. Sequencing was successful for 114/130 (87.7%) cfDNA samples and me-MFC results were analyzable for 196/205 (95.6%) samples. MM clones were detectable in 38.9% of samples taken at initial diagnosis or relapse (ID/RD), but only in 11.8% of samples taken during complete remission (CR). Circulating MM plasma cells were present in 83.3% of ID/RD samples and 9.9% of CR samples. Residual disease assessment by NGS or me-MFC in samples taken during very good partial remission or CR was 80% concordant. Notably, 4/4 (NGS) and 5/8 (me-MFC) positive CR samples were from patients with oligo- or non-secretory myeloma. The time to progression was shorter if there was evidence of residual myeloma in the pB. Together, our findings indicate that our two novel analytical approaches accurately indicate the course of MM and may be particularly valuable for monitoring patients with serologically non-trackable disease.

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This article draws on direct archival evidence from the Committee responsible for drafting the Gesetz gegen Wettbewerbsbeschränkungen 1957 (GWB) to establish what the priorities and beliefs of the Ordoliberals (broadly construed) were during the mid‐ to late‐1950s. This is done primarily by analysing the views expressed by Franz Böhm, Finance Minister Ludwig Erhard and Alfred Müller‐Armack. This work is important as it challenges the current understanding of Ordoliberalism. It reveals that aspects of the current understanding of Ordoliberalism are either flawed or do not take into account the changes that occurred between the submission of the Josten Draft (1949) and the drafting of the GWB (enacted 1957). This evidence also challenges the argument that the influence of Ordoliberalism on EU competition law has been exaggerated.

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