The genetics of multiple myeloma

What genetic abnormalities contribute to multiple myeloma? One intriguing and confounding issue in myeloma research is the heterogeneity of the genetic abnormalities that influence disease progression and therapeutic response. Moreover, because of the tumor-host interactions, alterations in gene expression occur within the normal cells of the bone marrow microenvironment, and contribute to complications and disease progression. While there are currently no known genetic alterations that are associated with every case of myeloma, there are some genetic abnormalities found in a relatively high percentage of cases. These abnormalities are mutations, deletions, translocations, and aberrant expression of various genes, such as oncogenes, tumor suppressor genes, growth factor receptor genes, genes responsible for adhesion, and apoptotic protecting genes. These abnormalities may affect growth and death pathways, as well as alter signal transduction pathways leading to activation of transcription factors. New directives by the National Cancer Institute that promote the use of new genetic technologies will greatly refine cancer classification and facilitate novel approaches to myeloma therapy.