Molecular pathogenesis of multiple myeloma: basic and clinical updates

作者: Marta Chesi , P. Leif Bergsagel

DOI: 10.1007/S12185-013-1291-2

关键词: Chromosomal translocationImmunoglobulin geneBortezomibHematologyNeuroblastoma RAS viral oncogene homologMultiple myelomaKRASEctopic expressionBiologyGeneticsInternal medicine

摘要: Multiple myeloma is divided into two distinct genetic subtypes based on chromosome content. Hyperdiploid characterized by multiple trisomies of chromosomes 3, 5, 7, 9 11, 15, 19 and 21, lacks recurrent immunoglobulin gene translocations. Non-hyperdiploid in contrast translocations t(4;14), t(14;16), t(14;20), t(6;14) t(11;14). A unifying event the pathogenesis dysregulated expression a cyclin D gene, either directly juxtaposition to an enhancer, as result ectopic MAF family transcription factor, or indirectly yet unidentified mechanisms. Secondary events include rearrangements MYC, activating mutations NRAS, KRAS BRAF, promiscuous array that activate NFkB deletions 17p. Among poor-risk features are del 17p gains 1q. Available evidence supports use risk-stratified approach treatment patients with myeloma, early prolonged bortezomib particularly t(4;14)

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