Surreal illustration linking neuron-specific enolase (NSE), blood samples, and multiple myeloma within a bone marrow context.

Decoding Multiple Myeloma: Can a Simple Blood Test Predict Outcomes?

Reese Marlowe in Health & Wellness November 2025 • 4 min read.

"New research explores how neuron-specific enolase (NSE) levels could revolutionize diagnosis and treatment monitoring for multiple myeloma, offering hope for better patient outcomes."

Multiple myeloma (MM), a cancer of plasma cells in the bone marrow, presents significant challenges in treatment and monitoring. Currently, doctors rely on bone marrow biopsies, protein level checks, and imaging to track the disease. Finding reliable and less invasive markers to predict how well a patient will respond to treatment and how the disease will progress is crucial.

Recent research has focused on neuron-specific enolase (NSE), an enzyme found in nerve and endocrine tissues, as a potential marker in MM. While traditionally used in lung cancer diagnostics, its role in MM is now being explored. Higher NSE levels have been linked to poorer outcomes in some cancers, prompting scientists to investigate its significance in myeloma.

This article delves into a study that examines NSE levels in MM patients before and after chemotherapy. It seeks to determine if NSE can serve as a valuable biomarker for diagnosis, treatment evaluation, and predicting the course of the disease, potentially leading to more personalized and effective treatment strategies.

How Can NSE Levels Help Manage Multiple Myeloma?

Surreal illustration linking neuron-specific enolase (NSE), blood samples, and multiple myeloma within a bone marrow context.

The study involved measuring NSE levels in 52 MM patients, comparing them to healthy individuals and patients with lung cancer. Researchers used a highly sensitive method called electrochemiluminescence immunoassay (ECLIA) to detect NSE in blood samples. They also examined bone marrow biopsies from MM patients to assess NSE expression directly in plasma cells.

The research team closely monitored other disease indicators like beta-2 microglobulin (β2-MG), a known marker of MM severity, along with patient symptoms and treatment responses. By tracking these factors alongside NSE levels, they aimed to understand how NSE relates to the overall disease state and treatment effectiveness.

Key findings from the study include:

MM patients often have elevated NSE levels compared to healthy individuals.
NSE levels tend to decrease after successful chemotherapy.
Higher NSE levels correlate with higher levels of β2-MG, indicating more advanced disease.
Changes in NSE levels appear to be linked to how long a patient stays in remission (progression-free survival).

These results suggest that NSE could provide valuable insights into how well chemotherapy is working and how the disease is progressing. It might serve as an early warning sign, helping doctors adjust treatment plans to improve patient outcomes. The study also found a strong link between NSE detected in blood samples and NSE expression in bone marrow plasma cells, reinforcing its potential as a reliable marker.

The Future of MM Treatment: Personalizing Care with NSE

The study indicates that monitoring NSE levels in MM patients holds significant promise. By tracking these levels, clinicians may gain a better understanding of treatment efficacy and disease progression. This could lead to more informed decisions about when to adjust therapy, potentially improving long-term outcomes.

While these findings are encouraging, further research is needed to fully validate the role of NSE in MM management. Larger studies with longer follow-up periods are necessary to confirm its prognostic value and explore how different treatment approaches affect NSE levels. Understanding these dynamics could pave the way for personalized treatment strategies tailored to individual patient profiles.

Ultimately, incorporating NSE monitoring into routine clinical practice could transform how MM is diagnosed, treated, and managed. Its ease of detection and relatively low cost make it a potentially valuable tool for improving patient care and advancing the fight against this challenging cancer.

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This article is based on research published under:

DOI-LINK: 10.1371/journal.pone.0094304, Alternate LINK

Title: Expression Of Neuron-Specific Enolase In Multiple Myeloma And Implications For Clinical Diagnosis And Treatment

Subject: Multidisciplinary

Journal: PLoS ONE

Publisher: Public Library of Science (PLoS)

Authors: Haiping Yang, Ruihua Mi, Qian Wang, Xudong Wei, Qingsong Yin, Lin Chen, Xinghu Zhu, Yongping Song

Published: 2014-05-05

Everything You Need To Know

What is neuron-specific enolase, and how might measuring it help with multiple myeloma?

Neuron-specific enolase, or NSE, is an enzyme traditionally used in diagnosing lung cancer but now being researched for its potential in managing multiple myeloma. Monitoring NSE levels can provide insights into how well chemotherapy is working and how the disease is progressing. Elevated NSE levels often correlate with advanced stages of multiple myeloma and can serve as an early warning sign, potentially helping doctors adjust treatment plans to improve patient outcomes. NSE’s utility lies in providing a less invasive method, compared to bone marrow biopsies, for tracking the disease.

How did the study measure neuron-specific enolase levels, and what were the key findings regarding multiple myeloma patients?

In the study, neuron-specific enolase levels were measured in patients with multiple myeloma and compared with those of healthy individuals and patients with lung cancer. The study utilized a highly sensitive method called electrochemiluminescence immunoassay to detect neuron-specific enolase in blood samples. Researchers also examined bone marrow biopsies to assess NSE expression directly in plasma cells. Key findings included elevated NSE levels in multiple myeloma patients compared to healthy individuals, a decrease in NSE levels post-chemotherapy, and a correlation between higher NSE levels and higher levels of beta-2 microglobulin, which indicates more advanced disease. These changes are associated with how long a patient stays in remission.

What is beta-2 microglobulin, and how does it relate to neuron-specific enolase levels in multiple myeloma?

Beta-2 microglobulin is a known marker of multiple myeloma severity, and the research showed a strong correlation between beta-2 microglobulin and neuron-specific enolase levels. Higher levels of NSE often corresponded with higher beta-2 microglobulin levels, indicating a more advanced stage of the disease. This suggests that NSE could serve as an additional tool for assessing the severity of multiple myeloma, potentially providing a more comprehensive understanding when used alongside beta-2 microglobulin. Using both markers may refine risk stratification and inform more tailored treatment approaches.

How does electrochemiluminescence immunoassay work, and why is it important for measuring neuron-specific enolase in multiple myeloma?

Electrochemiluminescence immunoassay, or ECLIA, offers a highly sensitive and specific method for detecting neuron-specific enolase in blood samples. This sensitivity is crucial for accurately measuring NSE levels, even when they are low, providing a more precise assessment of disease progression and treatment response in patients with multiple myeloma. The use of such a precise method enhances the reliability of neuron-specific enolase as a biomarker, thereby improving clinical decision-making.

What is the potential for personalizing multiple myeloma treatment based on neuron-specific enolase levels?

The potential to personalize treatment for multiple myeloma based on neuron-specific enolase levels represents a significant advancement. By monitoring NSE levels, clinicians can gain insights into how effectively treatments are working and how the disease is progressing. This understanding allows for timely adjustments to therapy, optimizing treatment plans to improve long-term outcomes for multiple myeloma patients. Tailoring treatment based on neuron-specific enolase levels may lead to more effective and targeted approaches, potentially reducing side effects and enhancing the quality of life for patients.