We have located links that may give you full text access.
ENGLISH ABSTRACT
JOURNAL ARTICLE
REVIEW
[Pathogenesis of multiple myeloma].
Der Internist 2019 January
BACKGROUND: Multiple myeloma (MM) is a hematologic malignancy characterized by monoclonal plasma cells infiltrating the bone marrow thereby causing anemia and lytic bone lesions. Despite significant improvement in overall survival, most MM patients inevitably, yet unpredictably, develop refractory disease and MM remains largely incurable.
OBJECTIVE: This article describes the stages of progression and presents current insights into the pathogenesis of MM.
MATERIAL AND METHODS: Discussion of basic conceptional works and most recent scientific publications.
RESULTS: Genetic predisposition, inflammation and abnormal immune response are responsible for the pathogenesis of MM. The initiating genomic event occurs during B cell maturation and clonal plasma cells are disseminated within the bone marrow (BM). This early stage is called monoclonal gammopathy of undetermined significance. The next stage of asymptomatic myeloma, shows a BM infiltration >10%. End organ damage defines symptomatic MM requiring treatment. According to most recent studies MM is characterized by spatial clonal heterogeneity, with aggressive clones frequently being restricted to focal lesions and therefore not being detectable at the iliac crest. Aggressive clones often present with complete inactivation of tumor suppressor genes, such as TP53 and are selected during treatment, which explains the difficulties in treating relapsed MM.
CONCLUSION: The tumor biology determines the progression of MM and underlies the heterogeneous response to treatment, which can be observed despite intensive treatment.
OBJECTIVE: This article describes the stages of progression and presents current insights into the pathogenesis of MM.
MATERIAL AND METHODS: Discussion of basic conceptional works and most recent scientific publications.
RESULTS: Genetic predisposition, inflammation and abnormal immune response are responsible for the pathogenesis of MM. The initiating genomic event occurs during B cell maturation and clonal plasma cells are disseminated within the bone marrow (BM). This early stage is called monoclonal gammopathy of undetermined significance. The next stage of asymptomatic myeloma, shows a BM infiltration >10%. End organ damage defines symptomatic MM requiring treatment. According to most recent studies MM is characterized by spatial clonal heterogeneity, with aggressive clones frequently being restricted to focal lesions and therefore not being detectable at the iliac crest. Aggressive clones often present with complete inactivation of tumor suppressor genes, such as TP53 and are selected during treatment, which explains the difficulties in treating relapsed MM.
CONCLUSION: The tumor biology determines the progression of MM and underlies the heterogeneous response to treatment, which can be observed despite intensive treatment.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
Perioperative echocardiographic strain analysis: what anesthesiologists should know.Canadian Journal of Anaesthesia 2024 April 11
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app