Molecular pathogenesis of multiple myeloma

Verfasser / Beitragende:
[Yusuke Furukawa, Jiro Kikuchi]
Ort, Verlag, Jahr:
2015
Enthalten in:
International Journal of Clinical Oncology, 20/3(2015-06-01), 413-422
Format:
Artikel (online)
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024 7 0 |a 10.1007/s10147-015-0837-0  |2 doi 
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245 0 0 |a Molecular pathogenesis of multiple myeloma  |h [Elektronische Daten]  |c [Yusuke Furukawa, Jiro Kikuchi] 
520 3 |a Multiple myeloma (MM), one of the most intractable malignancies, is characterized by the infiltration and growth of plasma cells, the most differentiated cells in the B-cell lineage, in the bone marrow. Despite the introduction of novel therapeutic agents, including proteasome inhibitors and immunomodulatory drugs, the prognosis of patients with MM is still worse than that of most hematological malignancies. A better understanding of the molecular pathogenesis of the disease is essential to achieve any improvement of treatment outcome of MM patients. All MM cases pass through the phase of asymptomatic expansion of clonal plasma cells, referred to as monoclonal gammopathy of undetermined significance (MGUS). It has long been believed that MM evolves linearly from MGUS to terminal phases, such as extramedullary tumors and plasma cell leukemia via the accumulation of novel mutations. However, recent studies using next-generation sequencing have disclosed the complex genomic architecture of the disease. At each step of progression, the acquisition of novel mutations is accompanied by subclonal evolution from reservoir cloneswith branching patterns. Each subclone may carry novel mutations and distinct phenotypes, including drug sensitivity. In addition, minor clones already exist at the MGUS stage, which could expand later in the clinical course, resulting in relapse and/or leukemic conversion. The ultimate goal of treatment is to eradicate all clones, including subclonal populations with distinct biological characteristics. This goal could be achieved by further improving treatment strategies that reflect the genomic landscape of the disease. 
540 |a Japan Society of Clinical Oncology, 2015 
690 7 |a Genetic architecture  |2 nationallicence 
690 7 |a Linear clonal evolution  |2 nationallicence 
690 7 |a Branching evolution  |2 nationallicence 
690 7 |a Intra-clonal heterogeneity  |2 nationallicence 
690 7 |a Drug resistance  |2 nationallicence 
700 1 |a Furukawa  |D Yusuke  |u Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan  |4 aut 
700 1 |a Kikuchi  |D Jiro  |u Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan  |4 aut 
773 0 |t International Journal of Clinical Oncology  |d Springer Japan  |g 20/3(2015-06-01), 413-422  |x 1341-9625  |q 20:3<413  |1 2015  |2 20  |o 10147 
856 4 0 |u https://doi.org/10.1007/s10147-015-0837-0  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
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950 |B NATIONALLICENCE  |P 700  |E 1-  |a Furukawa  |D Yusuke  |u Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kikuchi  |D Jiro  |u Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t International Journal of Clinical Oncology  |d Springer Japan  |g 20/3(2015-06-01), 413-422  |x 1341-9625  |q 20:3<413  |1 2015  |2 20  |o 10147