Multiple myeloma is a cancer in which immunoglobulin-producing plasma cells undergo clonal expansion. Its characteristic feature is the monoclonal, or M, spike, usually detectable in serum or urine by protein electrophoresis. There is a variety of chromosomal rearrangements, which in many cases lead to aberrant gene expression, some of which encode for factors that can modify the microenvironment in a manner that favors tumour growth or promotes its ability to spread, or affect the function of other tissues. The disease progresses in a step-like fashion due to additional genetic events within the malignant clone. Tremendous advances are being made in the understanding of the biology of myeloma and its treatment.
Author(s): Peter R. Galbraith MD, FRCP(C)
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