Introduction to Multiple Myeloma, Multiple Myeloma (MM)

Introduction to Multiple Myeloma, Interactive Exercise: Cancer Vocabulary

Introduction to Multiple Myeloma, Spectrum of Diseases

Introduction to Multiple Myeloma, Prevalence of Multiple Myeloma

Introduction to Multiple Myeloma, Monoclonal Gammopathy of Undetermined Significance (MGUS)

Introduction to Multiple Myeloma, Prevalence of Monoclonal Gammopathy of Undetermined Significance (MGUS)

Introduction to Multiple Myeloma, Myeloma Etiology

Multiple myeloma (MM):

• Malignancy of plasma cells
• Clonal plasma (myeloma) cells in bone marrow
• Lytic bone lesions (holes in the bone)
• M protein in blood or urine

B cell:

• One of the two major types of lymphocytes (white blood cells)

Plasma cell:

• An antibody-secreting cell derived from an antigen-activated B cell

Monoclonal:

• Derived from a single common ancestor cell

Immunoglobulin:

• A general term for antibodies

Translocation:

• Mutation in which a segment of one chromosome breaks off and attaches to another chromosome

Oncogene:

• Mutant form of a normal gene involved in cell growth

Tumor suppressor gene:

• A gene that acts to prevent cell growth

Hematologic:

• Of the blood

• Multiple myeloma (Malignant Plasmacytoma, Plasma Cell Dyscrasia, Plasma Cell Myeloma, Plasmacytoma of Bone)
• Different types of myeloma:
  • Asymptomatic (smoldering)
  • Symptomatic
  • Non-secretory
  • Bone marrow plasmacytosis 
  • Myeloma-related organ or tissue impairment
  • Solitary plasmacytoma of bone
  • Extramedullary plasmacytoma
  • Multiple solitary plasmacytomas +/- recurrent
  • Plasma cell leukemia

Prevalence of multiple melanoma:

• 2nd most prevalent blood cancer after non-Hodgkin’s lymphoma
• 1% of all cancers
• 2% of all cancer deaths
• 5.5 per 100,000 people in U.S.
  • Death rate 3.8/100,000
  • 5-year survival rate 33%
  • 3-year median survival 
• Prevalence increases with age
  • 7 in 100 000 for age 50 and older
  • 20 in 100 000 for age 70 and older
  • Median age 70 years of age
• Higher incidence in blacks and men

Monoclonal Gammopathy of Undetermined Significance (MGUS):

• No symptoms
• Plasma-like cells in bone marrow (
• M-protein in blood or urine (

Normal Plasma cells in bone marrow: 0.25-1.0%
Normal Serum Ig (IgG, IgA, IgM) proteins: 0.7-2.2 g/dL

Monoclonal Gammopathy of Undetermined Significance (MGUS):

• 2% of persons 50 years of age or older
  • 1% of MGUS patients per year progress to multiple myeloma
    • Progression likely due to random mutation

Myeloma Etiology:

• Cause unclear but correlated with:
  • Herbicides & insecticides
  • Chronic exposure to antigens
  • Radiation
  • Organic solvents
  • Genetic factors
  • Viruses and other infectious agents

Coriu D, et al. A Molecular Basis for Nonsecretory Myeloma. Blood. 2004 Aug 1; 104(3):829-31.

Greipp PR. Smoldering, Asymptomatic Stage 1, and Indolent Myeloma. Curr Treat Options Oncol. 2000 Jun; 1(2):119-26.

Kastrinakis, et al. Molecular Aspects of Multiple Myeloma. Ann Oncol. 2000 Oct; 11(10):1217-28.

Terstappen LW, et al. Identification and Characterization of Plasma Cells in Normal Human Bone Marrow by High-Resolution Flow Cytometry. Blood. 1990 Nov 1; 76(9):1739-47.

Plasma cell: A type of white blood cell that produces antibodies.

Clone: A set of genetically identical cells derived from a single ancestral cell.

M protein: Antibody and antibody fragments produced by myeloma cells.