Multiplemyeloma

W. Michael Kuehl, P. Leif Bergsagel

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The term “multiple myeloma” was suggested by von Rustizky in 1873, when he identified multiple discrete bone marrow (myel-) tumors (-oma) during an autopsy. Multiple myeloma (MM) is an age-dependent monoclonal tumor of bone marrow (BM) plasma cells (PC), often with significant end-organ damage that can include lytic bone lesions, anemia, loss of kidney function, immunodeficiency, and amyloid deposits in various tissues. With a yearly incidence of 20 000 in the USA, it accounts for nearly 20% of deaths from hematopoietic malignancies and about 2% of all deaths from cancer. Despite recent therapeutic advances, MM continues as a mostly incurable disease, but with a median survival that has increased to more than six years (1–4). Multiple myeloma is a plasmablast/plasma-cell tumor of post-germinal center B cells Pre-germinal center (GC) B cells can generate short-lived PC that mostly remain in the primary lymphoid tissue (Figure 74.1). Post-GC B cells can generate plasmablasts (PBs) that have successfully completed multiple rounds of somatic hypermutation and antigen selection, followed by IgH switch recombination, with both B-cell-specific DNA modification processes having oncogenic potential (5). These PB typically migrate to the BM, where stromal cells facilitate terminal differentiation into long-lived PC (6,7). Despite an aberrant immunophenotype, MM tumor cells are similar to post-GC PB/long-lived PC, including strong BM dependence, extensive somatic mutation of Ig genes, and absence of IgM expression in all but 1% of tumors.

Original languageEnglish (US)
Title of host publicationMolecular Oncology
Subtitle of host publicationCauses of Cancer and Targets for Treatment
PublisherCambridge University Press
Pages799-808
Number of pages10
ISBN (Electronic)9781139046947
ISBN (Print)9780521876629
DOIs
StatePublished - Jan 1 2015

ASJC Scopus subject areas

  • Medicine(all)

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