Article

A Case Study Progression to Multiple Myeloma

Mary Ann Yancey

Adam J. Waxman

Ola Landgren

multiple myeloma
CJON 2010, 14(4), 419-422. DOI: 10.1188/10.CJON.419-422

Multiple myeloma consistently is preceded by precursor states, which often are diagnosed incidentally in the laboratory. This case report illustrates the clinical dilemma of progression from precursor to full malignancy. The article also discusses future directions in management and research focusing on myelomagenesis.

Jump to a section

    References

    Barlogie, B., van Rhee, F., Shaughnessy, J. D., Jr., Epstein, J., Yaccoby, S., Pineda-Roman, M., … Zeldis, J. B. (2008). Seven-year median time to progression with thalidomide for smoldering myeloma. Blood, 112, 3122-3125. doi: 10.1182/blood-2008-06-164228
    Blade, J., Dimopoulos, M., Rosinol, L., Rajkumar, S. V., & Kyle, R. A. (2010). Smoldering (asymptomatic) multiple myeloma: Current diagnostic criteria, new predictors of outcome, and follow-up recommendations. Journal of Clinical Oncology, 28, 690-697. doi: 10.1200/JCO.2009.22.2257
    Dispenzieri, A., Kyle, R. A., Katzmann, J. A., Therneau, T. M., Larson, D., Benson, J., … Rajkumar, S. V. (2008). Immunoglobulin free light chain ratio is an independent risk factor for progression of smoldering (asymptomatic) multiple myeloma. Blood, 111, 785-789. doi: 10.1182/blood-2007-08-108357
    Hjorth, M., Hellquist, L., Holmberg, E., Magnusson, B., Rödjer, S., & Westin, J. (1993). Initial versus deferred melphalan-prednisone therapy for asymptomatic multiple myeloma stage I—A randomized study. European Journal of Haematology, 50, 95-102.
    International Myeloma Working Group. (2003). Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders. British Journal of Haematology, 121, 749-757. doi: 10.1046/j.1365-2141.2003.04355.x
    Kumar, S. K, Rajkumar, S. V., Dispenzieri, A., Lacy, M. Q., Hayman, S. R., Buadi, F. K., … Gertz, M. A. (2008). Improved survival in multiple myeloma and the impact of novel therapies. Blood, 111, 2516-2520. doi: 10.1182/blood-2007-10-116129
    Kyle, R. A., & Rajkumar, S. V. (2004). Multiple myeloma. New England Journal of Medicine, 351, 1860-1873.
    Kyle, R. A., Remstein, E. D., Therneau, T. M., Dispenzieri, A., Kurtin, P. J., Hodnefield, J. M., & Rajkumar, S. V. (2007). Clinical course and prognosis of smoldering (asymptomatic) multiple myeloma. New England Journal of Medicine, 356, 2582-2590. doi: 10.1056/NEJMoa070389
    Kyle, R. A., Therneau, T. M., Rajkumar, S. V., Offord, J. R., Larson, D. R., Plevak, M. F., & Melton, L. J., 3rd. (2002). A long-term study of prognosis in monoclonal gammopathy of undetermined significance. New England Journal of Medicine, 346, 564-569.
    Landgren, O., Kyle, R. A., Pfeiffer, R. M., Katzmann, J. A., Caporaso, N. E., Hayes, R. B., & Rajkumar, S. V. (2009). Monoclonal gammopathy of undetermined significance (MGUS) consistently precedes multiple myeloma: A prospective study. Blood, 113, 5412-5417. doi: 10.1182/blood-2008-12-194241
    Laubach, J. P., Richardson, P. G., & Anderson, K. C. (2010). The evolution and impact of therapy in multiple myeloma. Medical Oncology, 27(Suppl.), S1-S6. doi: 10.1007/s12032-010-9442-2
    Mateos, M. V., Lopez-Corral, L., Hernandez, M. T., de la Rubia, J., Lahuerta, J. J., Giraldo, P., … San-Miguel, J. F. (2009). Multicenter, randomized, open-label, phase III trial of lenalidomide-dexamethasone (len/dex) vs therapeutic abstention in smoldering multiple myeloma at high risk of progression to symptomatic MM. Retrieved from http://ash.confex.com/ash/2009/webprogram/Paper21268.html
    Musto, P., Petrucci, M. T., Bringhen, S., Guglielmelli, T., Caravita, T., Bongarzoni, V., … Palumbo, A. (2008). A multicenter, randomized clinical trial comparing zoledronic acid versus observation in patients with asymptomatic myeloma. Cancer, 113, 1588-1595. doi: 10.1002/cncr.23783
    Perez-Persona, E., Vidriales, M. B., Mateo, G., García-Sanz, R., Mateos, M. V., de Coca, A. G., … San Miguel, J. F. (2007). New criteria to identify risk of progression in monoclonal gammopathy of uncertain significance and smoldering multiple myeloma based on multiparameter flow cytometry analysis of bone marrow plasma cells. Blood, 110, 2586-2592. doi: 10.1182/blood-2007-05-088443
    Rajkumar, S. V., Kyle, R. A., Therneau, T. M., Melton, L. J., 3rd, Bradwell, A. R., Clark, R. J., … Katzmann, J. A. (2005). Serum free light chain ratio is an independent risk factor for progression in monoclonal gammopathy of undetermined significance. Blood, 106, 812-817. doi: 10.1182/blood-2005-03-1038
    Rajkumar, S. V., Lacy, M. Q., & Kyle, R. A. (2007). Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma. Blood Reviews, 21, 255-265. doi: 10.1016/j.blre.2007.01.002
    Turesson, I., Velez, R., Kristinsson, S. Y., & Landgren, O. (2009). Patterns of improved survival in patients with multiple myeloma in the twenty-first century: A population-based study. Journal of Clinical Oncology, 28, 830-834. doi: 10.1200/JCO.2009.25.4177
    Waxman, A., Kuehl, M., Balakumaran, A., Weiss, B., & Landgren, O. (in press). Smoldering (asymptomatic) multiple myeloma: Revisiting the clinical dilemma and looking into the future. Clinical Lymphoma, Myeloma, and Leukemia.
    Weiss, B. M., Abadie, J., Verma, P., Howard, R. S., & Kuehl, W. M. (2009). A monoclonal gammopathy precedes multiple myeloma in most patients. Blood, 113, 5418-5422. doi: 10.1182/blood-2008-12-195008