Multiple Myeloma

Click the image above to watch the Multiple Myeloma Overview - BCL, B-cell lymphoma; BLIMP, B lymphocyte-induced maturation protein; IRF, interferon regulatory factor; Pax, paired box; Xbp, X-box binding protein

Multiple myeloma is an incurable hematologic cancer of plasma cells characterized by increased monoclonal (M) protein levels in the serum and/or urine due to proliferation of malignant clonal plasma cells.1-4 The exact cause of multiple myeloma is unknown.2 The clinical manifestations of multiple myeloma include renal impairment, anemia, calcium elevation, and bone lesions.1 Monoclonal plasma cells proliferate in the bone marrow and are capable of invading adjacent bone, resulting in bone pain, fractures, and skeletal destruction.1,2 Patients commonly present with anemia (more than two-thirds of patients) and renal impairment (one-fifth of patients).1 Weakness and fatigue are common presentations due to anemia.1 Multiple myeloma is associated with regrowth of residual tumor and immune suppression.5,6 Multiple myeloma cells are able to evade detection by the immune system through altering of their phenotype and simultaneously inducing the production of immune-suppressing cytokines and other molecules.6

Plasma cells transform into malignant myeloma cells through the acquisition of genetic events, activation of key signaling pathways, and aberrant stromal and cellular signaling.7-14 Aberrant expression and/or over expression of key transcription factors and proliferative factors facilitate this malignant process.7,11,12

Explore the 3-D body to review the clinical manifestations of multiple myeloma. Share this interactive resource with your patients to further their understanding of the disease.

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Multiple Myeloma

Click on the '+' icon over the various areas of the body to explore the different clinical manifestations of multiple myeloma.

Disease State Healthy State

Use the navigation buttons on the right to zoom into areas of interest, zoom out to see surrounding structures, center your view, draw on a 2D snapshot, or email a 3D interactive link.

Calcium Elevation Due to Bone Disease

Use the toggle buttons below to see the increase in calcium levels in the blood stream due to bone disease associated with multiple myeloma compared with normal blood which has lower levels of calcium.

Disease State Normal State
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Anemia Due to Low Blood Counts

Use the toggle buttons below to see how multiple myeloma results in impaired production of normal cells resulting in anaemia due to reduced red blood cells compared with normal blood.

Disease State Normal State
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Renal Dysfunction

Use the toggle buttons below to see impaired kidney function associated with multiple myeloma due to various causes compared with normal kidney function.

Disease State Healthy State
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Bone Disease

Use the toggle buttons below to see the weakening of bone due to bone disease in multiple myeloma compared with healthy bone.

Click the '+' icon over the femur cross-section to explore bone lesions resulting in bone destruction in multiple myeloma.

Disease State Healthy State
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Bone Lesions

Use the toggle buttons below to see how impaired bone growth and repair by reduced osteoblast and increased osteoclasts as well as osteolytic lesions (not shown) weaken bone in multiple myeloma compared with healthy bones.

Disease State Healthy State
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The safety and efficacy of the agents and/or uses under investigation have not been established. There is no guarantee that the agents will receive health authority approval or become commercially available in any country for the uses being investigated

References

  1. International Myeloma Working Group. Br J Haematol. 2003;121:749-757.
  2. Kyle RA, et al. Best Pract Res Clin Haematol. 2007;20:637-664.
  3. Harousseau J-L. Cancer Treat Rev. 2010;36(suppl 2):S33-S35.
  4. Dimopoulos MA, et al. Leukemia. 2009;23:2147-2152.
  5. Corradini P, et al. Blood. 2003;102:1927-1929.
  6. Cook G, et al. Blood Rev. 1999;13:151-162.
  7. Morgan GJ, et al. Nat Rev Cancer. 2012;12:335-348.
  8. Raab MS, et al. Lancet. 2009;374:324-339.
  9. Podar K, et al. Expert Opin Emerg Drugs. 2009;14:99-127.
  10. Gupta D, et al. Leukemia. 2001;15:1950-1961.
  11. Jourdan M, et al. Eur Cytokine Netw. 1999;10:65-70.
  12. Laubach J, et al. Ann Rev Med. 2011;62:249-264.
  13. Shaffer AL, et al. Clin Cancer Res. 2009;15:2954-2961.
  14. Leung-Hagesteijn C, et al. Cancer Cell. 2013;24:289-304.