Recent Advances in The Definition of the Molecular Alterations Occurring in Multiple Myeloma.

IF 2 4区 医学 Q3 HEMATOLOGY
Ugo Testa, Elvira Pelosi, Germana Castelli, Giuseppe Leone
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引用次数: 0

Abstract

Multiple myeloma (MM) is a disorder of the monoclonal plasma cells and is the second most common hematologic malignancy. MM initiation and progression are dependent upon complex genomic abnormalities. The current pathogenic model of MM includes two types of primary events, represented by chromosome translocations or chromosome number alterations resulting in hyperdiploidy. These primary molecular events are observed both in MM and in monoclonal gammopathy, its premalignant precursor. Subsequent genetic events allow the progression of monoclonal gammopathy to MM and, together with primary events, contribute to the genetic complexity and heterogeneity of MM. Newer therapies have considerably improved patient outcomes; however, MM remains an incurable disease and most patients experience multiple relapses. The dramatic progresses achieved in the analysis of the heterogeneous molecular features of different MM patients allowed a comprehensive molecular classification of MM and the definition of an individualized prognostic model to predict an individual MM patient's response to different therapeutic options. Despite these progresses, prognostic models fail to identify a significant proportion of patients destined to early relapse. Treatment strategies are increasingly. Based on disease biology, trials are enriched for high-risk MMs, whose careful definition and categorization requires DNA sequencing studies.

多发性骨髓瘤分子变异定义的最新进展。
多发性骨髓瘤(MM)是一种单克隆浆细胞疾病,是第二大最常见的血液系统恶性肿瘤。多发性骨髓瘤的发生和发展取决于复杂的基因组异常。目前 MM 的致病模式包括两类原发性事件,即染色体易位或染色体数目改变导致的超二倍体。这些原发性分子事件在 MM 及其恶性前体单克隆性腺病中都可观察到。随后发生的遗传事件使单克隆丙种球蛋白病发展为 MM,并与原发事件一起导致 MM 遗传的复杂性和异质性。新疗法大大改善了患者的预后,但 MM 仍是一种无法治愈的疾病,大多数患者会经历多次复发。在分析不同 MM 患者的异质性分子特征方面取得的巨大进步,使得 MM 的分子分类得以全面展开,并定义了个体化预后模型,以预测 MM 患者对不同治疗方案的反应。尽管取得了这些进展,但预后模型仍无法识别相当一部分注定会早期复发的患者。治疗策略越来越多。根据疾病生物学原理,对高危 MM 进行了大量试验,而对高危 MM 的仔细定义和分类需要进行 DNA 测序研究。
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来源期刊
CiteScore
4.20
自引率
6.20%
发文量
113
审稿时长
12 weeks
期刊介绍: Reciprocal interdependence between infectious and hematologic diseases (malignant and non-malignant) is well known. This relationship is particularly evident in Mediterranean countries. Parasitosis as Malaria, Leishmaniosis, B Hookworms, Teniasis, very common in the southeast Mediterranean area, infect about a billion people and manifest prevalently with anemia so that they are usually diagnosed mostly by experienced hematologist on blood or bone marrow smear. On the other hand, infections are also a significant problem in patients affected by hematological malignancies. The blood is the primary vector of HIV infection, which otherwise manifest with symptoms related to a reduction in T lymphocytes. In turn, infections can favor the insurgency of hematological malignancies. The causative relationship between Epstein-Barr virus infection, Helicobacter pylori, hepatitis C virus, HIV and lymphoproliferative diseases is well known.
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