Multiple Myeloma: Increasing Evidence for a Multistep Transformation Process

• Published in: Blood Vol. 91; no. 1; pp. 3 - 21
• Main Authors: Hallek, Michael, Leif Bergsagel, P., Anderson, Kenneth C.
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 01.01.1998; The Americain Society of Hematology
• Subjects: Antigens, Surface - physiology; Apoptosis - genetics; Biological and medical sciences; Bone Marrow - pathology; Cell Adhesion Molecules - physiology; Cell Cycle; Cell Transformation, Neoplastic; DNA, Neoplasm - genetics; Drug Resistance, Multiple - genetics; Drug Resistance, Neoplasm - genetics; Genes, Retinoblastoma; Genes, Switch; Growth Substances - physiology; Hematologic and hematopoietic diseases; Humans; Immunoglobulin Heavy Chains - genetics; Interleukin-6 - antagonists & inhibitors; Interleukin-6 - physiology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymph Nodes - pathology; Medical sciences; Multiple Myeloma - etiology; Multiple Myeloma - genetics; Multiple Myeloma - immunology; Multiple Myeloma - pathology; Multiple Myeloma - therapy; Oncogenes; Plasma Cells - pathology; Signal Transduction; Translocation, Genetic; Human; Immunopathology; Immunoglobulinopathy; Pathogenesis; Lymphoproliferative syndrome; Malignant transformation; Malignant hemopathy; Myeloma; Carcinogenesis
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V91.1.3

Multiple Myeloma (Mm) is a clonal B-cell neoplasm that affects terminally differentiated B cells (ie, plasma cells) and may proceed through different phases: an inactive phase in which tumor cells are nonproliferating mature plasma cells, an active phase with a small percentage (<1%) of proliferating plasmablastic cells, and a fulminant phase with the frequent occurrence of extramedullary proliferation and an increase in plasmablastic cells. During the past years, considerable progress has been made in identifying some of the critical components of neoplastic transformation in MM. This review intends to propose a model of a stepwise malignant transformation during MM pathogenesis. Both diagnostic and therapeutic implications of this model will be discussed.