Immunobiology and Immunotherapy of Multiple Myeloma

摘要: Multiple myeloma (MM) is a common B-cell malignancy characterized by clonal expansion of transformed plasma cells in the bone marrow. 1 Natural history MM disease progression, and development anemia, lytic disease, infections. However, although an essential prerequisite for MM, most clinical outcome such expansions vivo humans not but monoclonal gammopathy undetermined significance (MGUS). MGUS has been estimated to occur up 1–3% elderly population, commonly viewed as preneoplastic state. patients with will generally remain stable throughout their life, only small proportion (estimated at about 1% per year) develop MM. 2 Another clinically distinct subset asymptomatic who also have relatively indolent course, much higher risk transformation symptomatic 3 Recent application interphase cytogenetics genomic technologies yielded surprising finding that many cytogenetic changes tumor initially identified can now be detected MGUS. 4 , 5 In instances, genetic lesions deletion chromosome 13 seem impart adverse do so These findings therefore suggest possibility depends on properties themselves host microenvironment interactions cells. An important component this immune system. 6 Therefore, improved understanding might provide newer approaches therapy prevention disease. Below, I first briefly discuss some general principles underlying mechanisms control escape tumors, then describe current studies status Understanding response step optimal therapeutic targeting system Chapter 11