ISSN:
1569-8041
Keywords:
cell cycle
;
cytogenetics
;
human herpesvirus 8
;
interleukin-6
;
multiple myeloma
;
therapy
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Multiple myeloma (MM) is a B-cell neoplasm characterized by bone marrowinfiltration with malignant plasma cells, which synthesize and secretemonoclonal immunoglobulin (Ig) fragments. Despite the considerable progressin the understanding of MM biology, the molecular basis of the disease remainselusive. The initial transformation is thought to occur in a post-germinalcenter B-lineage cell, carrying a somatically hypermutated Ig heavy chain(IGH) gene. This plasmablastic precursor cell colonizes the bone marrow,propagates clonally and differentiates into a slowly proliferating myelomacell population, all under the influence of specific cell adhesion moleculesand cytokines. Production of interleukin-6 by stromal cells, osteoblasts and,in some cases, neoplastic cells is an essential element of myeloma cellgrowth, with the cytokine stimulus being delivered intracellularly via theJack-STAT and ras signaling pathways. While karyotypic changes havebeen identified in up to 50% of MM patients, recent molecularcytogenetic techniques have revealed chromosomal abnormalities in the vastmajority of examined cases. Translocations mostly involve illegal switchrearrangements of the IGH locus with various partner genes (CCND1, FGFR3,c-maf). Such events have been assigned a critical role in MMdevelopment. Mutations in coding and regulatory regions, as well as aberrantexpression patterns of several oncogenes (c-myc, ras) andtumor suppressor genes (p16, p15) have been reported. Keyregulators of programmed cell death (BCL-2, Fas), tumor expansion(metalloproteinases) and drug responsiveness (topoisomerase II alpha) havealso been implicated in the pathogenesis of this hematologic malignancy. Atumorigenic role for human herpesvirus 8 (HHV8) was postulated recently,following the detection of viral sequences in bone marrow dendritic cells ofMM patients. However, since several research groups were unable to confirmthis observation, the role of HHV8 remains unclear. Translation of theadvances in MM molecular biology into novel therapeutic strategies isessential in order to improve disease prognosis.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008331714186
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