Biology And Management Of Multiple Myeloma

Expert physicians and clinical researchers summarize and explain all the recent advances in the biology and treatment of bone marrow-based malignancy. On the biological side, the authors show the characteristics of the malignant cell and describe the significant roles played by oncogenic changes, chromosomal anomalies, Kaposi's sarcoma herpes virus, and cytokines. New epidemiological findings and prognostic factors are also analyzed. On the clinical side, the authors provide a comprehensive review of conventional treatment regimens, as well as a discussion of newer experimental approaches involving immunologic targeting, inhibitors of drug resistance, and antitumor agents.

Despite the advances in conventional, novel agent and high dose chemotherapy multiple myeloma (MM) remains incurable. In order to overcome resistance to current therapies and improve patient outcome, novel biologically-based treatment approaches are being developed. Current translational research in MM focusing on the development of molecularly-based combination therapies has great promise to achieve high frequency and durable responses in the majority of patients. Two major advances are making this goal possible. First, recent advances in genomics and proteomics in MM have allowed for increased understanding of disease pathogenesis, identified novel therapeutic targets, allowed for molecular classification, and provided the scientific rationale for combining targeted therapies to increase tumor cell cytotoxicity and abrogate drug resistance. Second, there is now an increased understanding of how adhesion of MM cells in bone marrow (BM) further impacts gene expression in MM cells, as well as in BM stromal cells (BMSCs). As a result of these advances in oncogenomics on the one hand and increased understanding of the role of the BM in the pathogenesis of MM on the other, a new treatment paradigm targeting the tumor cell and its BM microenvironment to overcome drug resistance and improve patient outcome has now been developed. Thalidomide, lenalidomide, and Bortezomib are three agents which target the tumor cell in its microenvironment in both laboratory and animal models and which have rapidly translated from the bench to the bedside. Ongoing efforts are using oncogenomics and cell signaling studies to identify next generation of therapies in MM on the one hand, and to inform the design of combination trials on the other. This new paradigm for overcoming drug resistance and improving patient outcome in MM has great promise not only to change the natural history of MM, but also to serve as a model for targeted therapeutics directed to improve outcome of patients with MM.

This is a comprehensive, state-of-the-art guide to the diagnosis, treatment, and biology of multiple myeloma and related plasma disorders. Edited and written by a multidisciplinary group of recognized authorities from the Mayo Clinic, it presents clear guidelines on diagnosis and therapy and covers all aspects of multiple myeloma, from molecular classification and diagnosis, to risk stratification and therapy. Closely related plasma cell disorders such as solitary plasmacytoma, Waldenstrom macroglobulinemia, and light chain amyloidosis are discussed in detail as well. The book addresses often overlooked topics, including the role of radiation therapy, vertebral augmentation, and supportive care. Our understanding of this group of disorders is developing at an unprecedented rate, and Multiple Myeloma meets the need among oncologists and hematologists for a clear, timely, and authoritative resource on their biology, diagnosis, and treatment.

This unique book focuses on the non-myeloma plasma cell dyscrasias. A key resource for this group of diseases, the book features the latest in emerging knowledge and therapeutic developments, including novel therapies. Each disease-specific chapter discusses biology, disease course, and appropriate therapeutic interventions, covering plasma cell leukemia, plasmacytoma, POEMS Syndrome and Castleman's Disease, Waldenström macroglobulinemia, immunoglobin deposition disease, and cryoglobulinemic syndromes, among others. The only book dedicated to this intriguing family of diseases, Biology and Management of Unusual Plasma Cell Dyscrasias will be a long-lasting reference for clinicians and scientists alike.

The past few years have seen a rapidly developing interest in myeloma. There has been an explosion of new knowledge in the biology of the myeloma cell, and the first indications have appeared that some of this knowledge could be clinically applied. Newly accepted and successful treatments are now changing established practice in the therapy of myeloma. This book provides a major, comprehensive text on multiple myeloma. It covers pathophysiology, clincial features, complications and management, and is an authoritative guide to clinical practice, with a strong emphasis on the fundamental biology which underlies the disease.

This book is a practical guide to multiple myeloma. Beginning with the epidemiology, etiology and biology of the disease, the text then discusses clinical scenarios, diagnosis and various treatment options, including induction therapy, hematopoietic stem cell transplantation and treatment of relapsed/refractory cases. Authored by a US-based specialist, this book provides 166 detailed illustrations, tables, figures and algorithms to help understanding.

On March 27, 1990, the National Cancer Institute sponsored a workshop on the epidemiology of multiple myeloma, held at the National Institutes of Health. This book comprises articles prepared by participants in this work shop. Discussed in these papers are: the descriptive and analytic epidemi ology, differences in risk factors between blacks and whites, monoclonal gammopathies and their progression, and hypotheses regarding the etiology and pathogenesis of multiple myeloma. Several epidemiologic research areas received particular attention during this workshop, and are reviewed in detail in this volume. There have been striking increases in the incidence of multiple myeloma over the past thirty years, especially among older individuals and blacks, which may not be entirely explained by changes in diagnostic capabilities. Occupational and environmental exposures have been associated with an increased risk of multiple myeloma, including farming exposures, occupational exposure to petroleum and rubber processing, exposure to ionizing radiation, and asso ciations with persistent virus infections. The most striking epidemiological finding is reflected in the differences in incidence rates of multiple myeloma which are twice as high in blacks as compared with whites. Further, since 1950 the mortality rates for multiple myeloma have quadrupled in blacks while doubling for whites. Among hematopoietic malignancies, multiple myeloma is the only one with increased incidence and mortality rates among blacks. 1\vo major possibilities for explaining ethnic/racial differences in suscepti bility to multiple myeloma are genetic and environmental factors.