MULTIPLE MYELOMA (MM)
Multiple myeloma is a type of cancer of the plasma cells (a type of white blood cells) of the bone marrow. Plasma cells are protein-making cells that normally produce the different kinds of antibodies of the disease-fighting immune system. In multiple myeloma, the plasma cells undergo a malignant transformation and become cancerous. These myeloma cells stop making different forms of protein in response to the immune system's needs and instead start to produce a single abnormal type of protein sometimes termed a monoclonal or M protein. The cancerous myeloma plasma cells proliferate and crowd out normal plasma cells and can etch away areas of bones. The proteins produced in large amounts can cause many of the symptoms of the disease by making the blood more thickened and depositing the proteins in organs that can interfere with the functions of the kidneys, nerves, and immune system.
Patients with myeloma may be asymptomatic with an unexplained increase in protein in the blood. With more advanced disease, some myeloma patients may have weakness due to anemia caused by inadequate production of red blood cells, with bone pain due to the aforementioned bone damage, and as the abnormal M protein can accumulate in and damage the kidneys thereby resulting in a patient being found to have otherwise unexplained kidney damage and decreased kidney function. Patients may also present with weakness or fatigue, loss of appetite and weight loss, constipation, macroglossia, skin lesions, hypercalcemia, pathologic bone fractures, and spinal cord compression, and chronic back pain.
Common chromosome changes associated with multiple myeloma are listed below.
• 14q32 rearrangement IGHG1
• t(14;16)(q32;q23) IGHG1/MAF
• t(4;14)(p16;q32) IGHG1/FGFR3
• t(11;14)(q13;q32) IGHG1/CCND1
• del(17p13) TP53/CEP17
• del(13q14.2) RB1 LSI13q14/LSI13q34
• trisomy 9/trisomy 15
• trisomy 3/trisomy 7
• dup(1q21) CHD5/S100A10
• t(14;20)(q32;q12) IGHG1/MAFB
• t(6;14)(p21;q32) IGHG1/CCND3
FISH analysis can be performed to confirm diagnosis and/or monitor chromosome changes during treatment. Clinicians can order individual probes or the complete panel. Please refer to the Cytogenetics for Hematology/Oncology test order form to order testing and to review specimen requirements.
Karyotype analysis can also be performed to confirm the FISH results.
OUHSC Genetics Laboratory 1122 NE 13th Street, Suite 1400, Oklahoma City, OK 73104
Phone (405)271-3589 Fax (405)271-7117 After hours phone (405)496-9514
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