UPDATES IN THE PATHOGENESIS AND MANAGEMENT OF MULTIPLE MYELOMA

Abstract

Plasma cell is one of the white blood cells whose function is to immunoglobulins to fight infections,there are number of plasma cell disorders which are known as plasma cell dyscriasis,these include:multiple myeloma,monoclonal gammopathy of undetermined significance, waldenstroms macroglobulinaemia and heavy chain disease. Multiple myeloma is amalignant tumour of the terminally differentiated plasma cell.The possible aetiolgical factors for multiple myeloma includes environmental factors especially exposure to irradiation,certain chemicals and genetic factors. Since the first description of the disease now known as Multiple Myeloma (MM) by Dr. Solly in 1844 (first case report of MM , there has been a continually increasing interest in the clinical and pathophysiological information on MM and related diseases, accompanying a dramatic change in the understanding of the biology of the disease itself, diagnostic procedures and therapeutic approaches. Diagnostic parameters include conventional disease determinants, characterisation of bone marrow (BM) plasma cells, cytogenetics, but may also involve bone markers, the BM microenvironment (BMM) and signalling pathways. Since the determination of the frequent and complex genomic abnormalities in MM allows clarification of the pathogenesis of the disease and its prognosis, cytogenetics have become an important tool, and are currently used in the determination of risk factors for stratification in clinical trials. oncogenic pathways in the early development of clonal plasma cell disorders, where half of the tumours are non-hyperdiploid and carry translocations of the IgH locus and various oncogenes (e.g. cyclin D1,D3, FGFR3), and the remaining hyperdiploid tumours exhibit recurrent trisomies (typically of chromosomes 5,7,9,11,15,19 and 21), but infrequently exhibit IgH translocations.