Multiple myeloma

Multiple myeloma (also known simply as myeloma or plasma cell myeloma, or as Kahler's disease after Otto Kahler) is a presently incurable hematological malignancy of plasma cells, the cells of the immune system that produce antibodies. Although it initially develops in the bone marrow, it spreads to the peripheral blood, lymph nodes and other organs. Its prognosis despite therapy is generally poor, and treatment may involve chemotherapy and bone marrow transplant.

Pathophysiology

The accepted theory is that myeloma develops when a chromosomal translocation occurs between the immunoglobulin heavy chain gene (on the fourteenth chromosome, locus 14q32) and a gene that produces an oncogene (often 11q13, 4p16.3, 6p21, 16q23 and 20q11{{mn|Kyle|1}}). The result is proliferation of a plasma cell clone and genomic instability that leads to further mutations and translocations. The chromosome 14 abnormality is observed in about 50% of all cases of myeloma. Deletion of (parts of) the thirteenth chromosome is also observed in about 50% of cases.

Related Topics:
Chromosomal translocation - Chromosome - Oncogene - Genomic instability

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Production of cytokines (especially IL-6) by the plasma cells causes much of their localised damage, such as osteoporosis, and creates a microenvironment in which the malignant cells thrive. Angiogenesis (the attraction of new blood vessels) is increased.

Related Topics:
Cytokine - IL-6 - Osteoporosis - Angiogenesis

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The produced antibodies are deposited in various organs, leading to renal failure, polyneuropathy and various other myeloma-associated symptoms.

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