Dr Mantas Radzevičius is a doctor of laboratory medicine at Vilnius University Hospital Santaros Klinikos (VUH SK). On 15 May this year Mr Radzevičius defended his thesis entitled The Importance of Immunophenotyping of Malignant Plasma Cells in the Diagnosis of Multiple Myeloma and in the Assessment of Treatment Efficacy and Prognosis for the degree of doctor of medicine. Today we are talking with Mr Radzevičius about his PhD research and studies done at Vilnius University Faculty of Medicine.
Tell us more about your thesis. What research did you do?
Multiple myeloma, also known as myelomatous disease, is a malignant haematological disorder, which occurs when malignant plasma cells damage bone tissue, the bone marrow. This leads to bone fractures, more frequent infections, and anaemia. Normal plasma cells are responsible for the production of antibodies, while malignant cells produce protein M, which damages the kidneys. In my thesis, I first investigated how these malignant cell proteins, biomarkers, are involved in the aggressiveness of the disease, the spread from the bone marrow into the bloodstream, and how this spread is associated with the progression of the disease. Protein expression in cells can be measured by flow cytometry, which relies on single cell analysis to assess changes in protein expression and to detect extremely small amounts of cells. All this allows changes in the malignant plasma cells themselves to be assessed in different groups of patients when the disease becomes more aggressive. Another part of my work looked at the issue of minimal residual disease: this is the kind of test that allows the very small number of malignant cells that remain after treatment to be detected. We have collaborated with research centres abroad to standardise the analysis strategy for this test.
How is this topic relevant to society? What is the significance of the results of your study?
Multiple myeloma is the third most common onco-haematological disease, with about 150 cases diagnosed in Lithuania per year. The majority of cases are in the elderly, and although the disease is not completely curable, it is possible to achieve long-term remission with modern therapies. However, some patients relapse, become resistant to treatment, or, in more aggressive cases, the disease progresses. New testing and prognostic options are needed to predict this in advance. The findings of my study—protein changes associated with disease progression and high-risk genetic aberrations—may help in the future to better target groups of patients who may require individualised therapy.
Difficulties are perhaps inevitable when writing a paper of this level. What were some of them and how did you deal with them?
There were many difficulties: organisational, but also related to research design. I work in a laboratory, so without haematologists working directly with patients, it would not have been possible to carry out such studies, and I had to find physicians working in this field who were interested. There were other problems: patient involvement, study design, and implementation. I am grateful to my supervisor, Professor Zita Aušrele Kučinskienė, my thesis adviser, Doctor Valdas Pečeliūnas, and my colleagues in the laboratory who have been working on similar studies for a long time. Doctor Rėda Matuzevičienė, who has extensive experience in laboratory haematology and flow cytometry, was a great help. A PhD student should not be a lone soldier in the field. Sometimes it may seem that way, but you should never be afraid to ask for help when difficulties arise.
What kind of dissertation is a successful dissertation? What makes a dissertation successful?
I believe a successful dissertation is one that is first and foremost interesting to the person preparing it, not just because it is popular, or chart-topping, or there is pressure. Of course, the topic of the dissertation should also be relevant to people working in the field, in other words, applicable in practice. However, many dissertations still deal with rather narrow fields and the results are not always directly and quickly applicable. This is why basic scientific research, which can then be used as a basis for raising questions and proposing ideas in clinical trials, should be given due weight. If another scientist hears about a problem in your thesis and is inspired to develop similar ideas further, or perhaps in another field, that is a success.
It's well known that some PhD students drop out and don’t finish their dissertation. What do you think would help young researchers to keep going and to finish their PhD despite all the difficulties and challenges? What motivated you?
I was motivated by my whole environment: my colleagues and my family. Sometimes an unfinished dissertation can seem like a millstone around your neck, a sense of duty; like, you must finish what you have started. But you have to realise that sometimes the biggest difficulties and setbacks are not the fault of the dissertation, and it is better to accept that. As in life, we cannot control everything, nor should we be afraid to take a break if necessary. But above all, it is important not to be afraid to ask for help. Chances are that others have already experienced similar challenges to yours and will have useful advice to share.
Personal archive.
If you could go back, knowing what lies ahead, would you repeat this PhD experience? What would you do differently?
Yes, I would. Perhaps this kind of time travel would make things quicker, more efficient, easier, and without pitfalls. But without the mistakes made or the difficulties I experienced, there would be no lessons learned. What would I change? I would better plan the writing period, which only seems very long, but in reality, time is always short and most of the work is at the end, when your stress level is at its highest.
How has this experience shaped you as a person and as a scientist?
I have learnt to be humble, but also not to be afraid to ask for advice and help; there will always be scientists with a lot of experience to share. I have also learned to plan my work and my time better. And, of course, patience: many things don’t happen as quickly as you would like. As a scientist, I have learnt to plan my research more wisely, and I have learnt how important it really is to be prepared in advance, both in terms of ideas and knowledge, and in terms of anticipating potential problems.
What advice would you give to those who are just starting out on this difficult and challenging PhD adventure?
First of all, as with any adventure, you need to think things through. As the proverb says, “Measure twice, cut once”. On the other hand, you should realise that you can’t plan and preview everything. If you can, it’s great to try something smaller, like a pilot study, to see how the idea looks in reality. But also remember, colleagues or friends are invaluable sources of help. A supervisor or consultant can be a great source of inspiration, but often help and support can be found very close to home, for example in the family. Share your ideas and work with loved ones, colleagues, and they will surely surprise you with their insights.