Abstract
In recent years, significant progress has been made in understanding the molecular pathogenesis of multiple myeloma (MM). MM is characterized by the sequential multistage progressive accumulation of genetic abnormalities which lead to deregulation of key regulatory pathways. Numeric chromosomal abnormalities are present in almost all MM patients. Primary translocations occur early in MM pathogenesis, whereas secondary translocations are involved in progression. Chromosomal abnormalities include full or partial deletion of chromosome 13 and 17, amplification of chromosome 1, and recurrent 14q32 translocations. Hyperdiploidy is present in 45 % of patients. From the clinical point of view, the knowledge of MM molecular biology is important in making decisions about therapeutic choices and in designing novel molecule targeted drugs.
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Annunziata CM, Davis RE, Demchenko Y, Bellamy W, Gabrea A, Zhan F, Lenz G, Hanamura I, Wright G, Xiao W, Dave S, Hurt EM, Tan B, Zhao H, Stephens O, Santra M, Williams DR, Dang L, Barlogie B, Shaughnessy JD Jr, Kuehl WM, Staudt LM (2007) Frequent engagement of the classical and alternative NF-kappaB pathways by diverse genetic abnormalities in multiple myeloma. Cancer Cell 12:115–130
Avet-Loiseau H, Facon T, Daviet A, Godon C, Rapp MJ, Harousseau JL, Grosbois B, Bataille R (1999a) 14q32 translocations and monosomy 13 observed in monoclonal gammopathy of undetermined significance delineate a multistep process for the oncogenesis of multiple myeloma, Intergroupe Francophone du Myelome. Cancer Res 59:4546–4550
Avet-Loiseau H, Li JY, Morineau N, Facon T, Brigaudeau C, Harousseau JL, Grosbois B, Bataille R (1999b) Monosomy 13 is associated with the transition of monoclonal gammopathy of undetermined significance to multiple myeloma. Intergroupe Francophone du Myelome. Blood 94:2583–2589
Avet-Loiseau H, Facon T, Grosbois B, Magrangeas F, Rapp MJ, Harousseau JL, Minvielle S, Bataille R (2002) Oncogenesis of multiple myeloma: 14q32 and 13q chromosomal abnormalities are not randomly distributed, but correlate with natural history, immunological features, and clinical presentation. Blood 99:2185–2191
Avet-Loiseau H, Attal M, Moreau P, Charbonnel C, Garban F, Hulin C, Leyvraz S, Michallet M, Yakoub-Agha I, Garderet L, Marit G, Michaux L, Voillat L, Renaud M, Grosbois B, Guillerm G, Benboubker L, Monconduit M, Thieblemont C, Casassus P, Caillot D, Stoppa AM, Sotto JJ, Wetterwald M, Dumontet C et al (2007) Genetic abnormalities and survival in multiple myeloma: the experience of the Intergroupe Francophone du Myelome. Blood 109:3489–3495
Avet-Loiseau H, Li C, Magrangeas F, Gouraud W, Charbonnel C, Harousseau JL, Attal M, Marit G, Mathiot C, Facon T, Moreau P, Anderson KC, Campion L, Munshi NC, Minvielle S (2009) Prognostic significance of copy-number alterations in multiple myeloma. J Clin Oncol 27:4585–4590
Bergsagel PL, Kuehl WM, Zhan F, Sawyer J, Barlogie B, Shaughnessy J Jr (2005) Cyclin D dysregulation: an early and unifying pathogenic event in multiple myeloma. Blood 106:296–303
Bezieau S, Devilder MC, Avet-Loiseau H, Mellerin MP, Puthier D, Pennarun E, Rapp MJ, Harousseau JL, Moisan JP, Bataille R (2001) High incidence of N and K-Ras activating mutations in multiple myeloma and primary plasma cell leukemia at diagnosis. Human Mutat 18:212–224
Carrasco DR, Tonon G, Huang Y, Zhang Y, Sinha R, Feng B, Stewart JP, Zhan F, Khatry D, Protopopova M, Protopopov A, Sukhdeo K, Hanamura I, Stephens O, Barlogie B, Anderson KC, Chin L, Shaughnessy JD Jr, Brennan C, Depinho RA (2006) High-resolution genomic profiles define distinct clinico-pathogenetic subgroups of multiple myeloma patients. Cancer Cell 9:313–325
Chang H, Sloan S, Li D, Zhuang L, Yi QL, Chen CI, Reece D, Chun K, Keith Stewart A (2004a) The t(4;14) is associated with poor prognosis in myeloma patients undergoing autologous stem cell transplant. Br J Haematol 125:64–68
Chang H, Sloan S, Li D, Keith Stewart A (2004b) Multiple myeloma involving central nervous system: high frequency of chromosome 17p13.1 (p53) deletions. Br J Haematol 127:280–284
Chang H, Qi XY, Samiee S, Yi QL, Chen C, Trudel S, Mikhael J, Reece D, Stewart AK (2005) Genetic risk identifies multiple myeloma patients who do not benefit from autologous stem cell transplantation. Bone Marrow Transplant 36:793–796
Chang H, Qi X, Trieu Y, Xu W, Reader JC, Ning Y, Reece D (2006) Multiple myeloma patients with CKS1B gene amplification have a shorter progression-free survival post-autologous stem cell transplantation. Br J Haematol 135:486–491
Chesi M, Nardini E, Lim RS, Smith KD, Kuehl WM, Bergsagel PL (1998a) The t(4;14) translocation in myeloma dysregulates both FGFR3 and a novel gene, MMSET, resulting in IgH/MMSET hybrid transcripts. Blood 92:3025–3034
Chesi M, Bergsagel PL, Shonukan OO, Martelli ML, Brents LA, Chen T, Schröck E, Ried T, Kuehl WM (1998b) Frequent dysregulation of the c-maf proto-oncogene at 16q23 by translocation to an Ig locus in multiple myeloma. Blood 91:4457–4463
Chesi M, Robbiani DF, Sebag M, Chng WJ, Affer M, Tiedemann R, Valdez R, Palmer SE, Haas SS, Stewart AK, Fonseca R, Kremer R, Cattoretti G, Bergsagel PL (2008) AID-dependent activation of a MYC transgene induces multiple myeloma in a conditional mouse model of post-germinal center malignancies. Cancer Cell 13:167–180
Chiecchio L, Protheroe RK, Ibrahim AH, Cheung KL, Rudduck C, Dagrada GP, Cabanas ED, Parker T, Nightingale M, Wechalekar A, Orchard KH, Harrison CJ, Cross NC, Morgan GJ, Ross FM (2006) Deletion of chromosome 13 detected by conventional cytogenetics is a critical prognostic factor in myeloma. Leukemia 20:1610–1617
Chng WJ, Van Wier SA, Ahmann GJ, Winkler JM, Jalal SM, Bergsagel PL, Chesi M, Trendle MC, Oken MM, Blood E, Henderson K, Santana-Dávila R, Kyle RA, Gertz MA, Lacy MQ, Dispenzieri A, Greipp PR, Fonseca R (2005) A validated FISH trisomy index demonstrates the hyperdiploid and nonhyperdiploid dichotomy in MGUS. Blood 106:2156–2161
Chng WJ, Winkler JM, Greipp PR, Jalal SM, Bergsagel PL, Chesi M, Trendle MC, Ahmann GJ, Henderson K, Blood E, Oken MM, Hulbert A, Van Wier SA, Santana-Dávila R, Kyle RA, Gertz MA, Lacy MQ, Dispenzieri A, Fonseca R (2006a) Ploidy status rarely changes in myeloma patients at disease progression. Leuk Res 30:266–271
Chng WJ, Santana-Dávila R, Van Wier SA, Ahmann GJ, Jalal SM, Bergsagel PL, Chesi M, Trendle MC, Jacobus S, Blood E, Oken MM, Henderson K, Kyle RA, Gertz MA, Lacy MQ, Dispenzieri A, Greipp PR, Fonseca R (2006b) Prognostic factors for hyperdiploid-myeloma: effects of chromosome 13 deletions and IgH translocations. Leukemia 20:807–813
Chng WJ, Price-Troska T, Gonzalez-Paz N, Van Wier S, Jacobus S, Blood E, Henderson K, Oken M, Van Ness B, Greipp P, Rajkumar SV, Fonseca R (2007) Clinical significance of TP53 mutation in myeloma. Leukemia 21:582–584
Chng WJ, Gonzalez-Paz N, Price-Troska T, Jacobus S, Rajkumar SV, Oken MM, Kyle RA, Henderson KJ, Van Wier S, Greipp P, Van Ness B, Fonseca R (2008) Clinical and biological significance of RAS mutations in multiple myeloma. Leukemia 22:2280–2284
Debes-Marun CS, Dewald GW, Bryant S, Picken E, Santana-Dávila R, González-Paz N, Winkler JM, Kyle RA, Gertz MA, Witzig TE, Dispenzieri A, Lacy MQ, Rajkumar SV, Lust JA, Greipp PR, Fonseca R (2003) Chromosome abnormalities clustering and its implications for pathogenesis and prognosis in myeloma. Leukemia 17:427–436
Drach J, Ackermann J, Fritz E, Krömer E, Schuster R, Gisslinger H, DeSantis M, Zojer N, Fiegl M, Roka S, Schuster J, Heinz R, Ludwig H, Huber H (1998) Presence of a p53 gene deletion in patients with multiple myeloma predicts for short survival after conventional-dose chemotherapy. Blood 92:802–809
Fassas AB, Spencer T, Sawyer J, Zangari M, Lee CK, Anaissie E, Muwalla F, Morris C, Barlogie B, Tricot G (2002) Both hypodiploidy and deletion of chromosome 13 independently confer poor prognosis in multiple myeloma. Br J Haematol 118:1041–1047
Fonseca R, Bailey RJ, Ahmann GJ, Rajkumar SV, Hoyer JD, Lust JA, Kyle RA, Gertz MA, Greipp PR, Dewald GW (2002a) Genomic abnormalities in monoclonal gammopathy of undetermined significance. Blood 100:1417–1424
Fonseca R, Harrington D, Oken MM, Dewald GW, Bailey RJ, Van Wier SA, Henderson KJ, Blood EA, Rajkumar SV, Kay NE, Van Ness B, Greipp PR (2002b) Biologic and prognostic significance of interphase FISH detection of chromosome 13 abnormalities (D13) in multiple myeloma: an Eastern Cooperative Oncology Group (ECOG) Study. Cancer Res 62:715–720
Fonseca R, Debes-Marun CS, Picken EB, Dewald GW, Bryant SC, Winkler JM, Blood E, Oken MM, Santana-Dávila R, González-Paz N, Kyle RA, Gertz MA, Dispenzieri A, Lacy MQ, Greipp PR (2003a) The recurrent IgH translocations are highly associated with nonhyperdiploid variant multiple myeloma. Blood 102:2562–2567
Fonseca R, Blood E, Rue M, Harrington D, Oken MM, Kyle RA, Dewald GW, Van Ness B, Van Wier SA, Henderson KJ, Bailey RJ, Greipp PR (2003b) Clinical and biologic implications of recurrent genomic aberrations in myeloma. Blood 101:4569–4575
Fonseca R, Bergsagel PL, Drach J, Shaughnessy J, Gutierrez N, Stewart AK, Morgan G, Van Ness B, Chesi M, Minvielle S, Neri A, Barlogie B, Kuehl WM, Liebisch P, Davies F, Chen-Kiang S, Durie BG, Carrasco R, Sezer O, Reiman T, Pilarski L, Avet-Loiseau H (2009) International Myeloma working group molecular classification of multiple myeloma: spotlight review. Leukemia 23:2210–2221
Garand R, Avet-Loiseau H, Accard F, Moreau P, Harousseau JL, Bataille R (2003) t(11;14) and t(4;14) translocations correlated with mature lymphoplasmocytoid and immature morphology, respectively, in multiple myeloma. Leukemia 17:2032–2035
Gertz MA, Lacy MQ, Dispenzieri A, Greipp PR, Litzow MR, Henderson KJ, Van Wier SA, Ahmann GJ, Fonseca R (2005) Clinical implications of t(11;14)(q13;q32), t(4;14)(p16.3;q32) and -17p13 in myeloma patients treated with high-dose therapy. Blood 106:2837–2840
Gonzalez-Paz N, Chng WJ, McClure RF, Blood E, Oken MM, Van Ness B, James CD, Kurtin PJ, Henderson K, Ahmann GJ, Gertz M, Lacy M, Dispenzieri A, Greipp PR, Fonseca R (2007) Tumor suppressor p16 methylation in multiple myeloma: biological and clinical implications. Blood 109:1228–1232
Gutiérrez NC, Sarasquete ME, Misiewicz-Krzeminska I, Delgado M, De Las Rivas J, Ticona FV, Fermiñán E, Martín-Jiménez P, Chillón C, Risueño A, Hernández JM, García-Sanz R, González M, San Miguel JF (2010) Deregulation of microRNA expression in the different genetic subtypes of multiple myeloma and correlation with gene expression profiling. Leukemia 24:629–637
Hoyer JD, Hanson CA, Fonseca R, Greipp PR, Dewald GW, Kurtin PJ (2000) The (11;14)(q13;q32) translocation in multiple myeloma. A morphologic and immunohistochemical study. Am J Clin Pathol 113:831–837
Jenner MW, Leone PE, Walker BA, Ross FM, Johnson DC, Gonzalez D, Chiecchio L, Dachs Cabanas E, Dagrada GP, Nightingale M, Protheroe RK, Stockley D, Else M, Dickens NJ, Cross NC, Davies FE, Morgan GJ (2007) Gene mapping and expression analysis of 16q loss of heterozygosity identifies WWOX and CYLD as being important in determining clinical outcome in multiple myeloma. Blood 110:3291–3300
Keats JJ, Reiman T, Maxwell CA, Taylor BJ, Larratt LM, Mant MJ, Belch AR, Pilarski LM (2003) In multiple myeloma, t(4;14)(p16;q32) is an adverse prognostic factor irrespective of FGFR3 expression. Blood 101:1520–1529
Keats JJ, Fonseca R, Chesi M, Schop R, Baker A, Chng WJ, Van Wier S, Tiedemann R, Shi CX, Sebag M, Braggio E, Henry T, Zhu YX, Fogle H, Price-Troska T, Ahmann G, Mancini C, Brents LA, Kumar S, Greipp P, Dispenzieri A, Bryant B, Mulligan G, Bruhn L, Barrett M et al (2007) Promiscuous mutations activate the noncanonical NF-kappaB pathway in multiple myeloma. Cancer Cell 12:131–144
Kulkarni MS, Daggett JL, Bender TP, Kuehl WM, Bergsagel PL, Williams ME (2002) Frequent inactivation of the cyclin-dependent kinase inhibitor p18 by homozygous deletion in multiple myeloma cell lines: ectopic p18 expression inhibits growth and induces apoptosis. Leukemia 16:127–134
Lionetti M, Biasiolo M, Agnelli L, Todoerti K, Mosca L, Fabris S, Sales G, Deliliers GL, Bicciato S, Lombardi L, Bortoluzzi S, Neri A (2009) Identification of microRNA expression patterns and definition of a microRNA/mRNA regulatory network in distinct molecular groups of multiple myeloma. Blood 114:e20–e26
Liu P, Leong T, Quam L, Billadeau D, Kay NE, Greipp P, Kyle RA, Oken MM, Van Ness B (1996) Activating mutations of N- and K-ras in multiple myeloma show different clinical associations: analysis of the Eastern Cooperative Oncology Group Phase III Trial. Blood 88:2699–2706
Löffler D, Brocke-Heidrich K, Pfeifer G, Stocsits C, Hackermüller J, Kretzschmar AK, Burger R, Gramatzki M, Blumert C, Bauer K, Cvijic H, Ullmann AK, Stadler PF, Horn F (2007) Interleukin-6 dependent survival of multiple myeloma cells involves the Stat3-mediated induction of micro-RNA-21 through a highly conserved enhancer. Blood 110:1330–1333
Mateos MV, García-Sanz R, López-Pérez R, Moro MJ, Ocio E, Hernández J, Megido M, Caballero MD, Fernández-Calvo J, Bárez A, Almeida J, Orfão A, González M, San Miguel JF (2002) Methylation is an inactivating mechanism of the p16 gene in multiple myeloma associated with high plasma cell proliferation and short survival. Br J Haematol 118:1034–1040
Molnar S, Zepeda VJJ, Van Wier S, Braggio E, Keats J, Kuehl M, Price-Troska T, Ahmann G, Rempel R, Henderson K, Rajkumar SV, Greipp PR, Auclair D, Carpten J, Baker A, Stewart K, Bergsagel L, Chng WJ, Fonseca R (2008) Loss of p53 is a marker of progression in plasma cell neoplasias and is a negative prognostic factor in relapsed disease. Blood (ASH Annu Meet Abstr) 112:1663
Moreau P, Facon T, Leleu X, Morineau N, Huyghe P, Harousseau JL, Bataille R, Avet-Loiseau H (2002) Recurrent 14q32 translocations determine the prognosis of multiple myeloma, especially in patients receiving intensive chemotherapy. Blood 100:1579–1583
Moreau P, Robillard N, Jégo G, Pellat C, Le Gouill S, Thoumi S, Avet-Loiseau H, Harousseau JL, Bataille R (2006) Lack of CD27 in myeloma delineates different presentation and outcome. Br J Haematol 132:168–170
Pichiorri F, Suh SS, Ladetto M, Kuehl M, Palumbo T, Drandi D, Taccioli C, Zanesi N, Alder H, Hagan JP, Munker R, Volinia S, Boccadoro M, Garzon R, Palumbo A, Aqeilan RI, Croce CM (2008) MicroRNAs regulate critical genes associated with multiple myeloma pathogenesis. Proc Natl Acad Sci USA 105:12885–12890
Rasmussen T, Kuehl M, Lodahl M, Johnsen HE, Dahl IM (2005) Possible roles for activating RAS mutations in the MGUS to MM transition and in the intramedullary to extramedullary transition some plasma cell tumors. Blood 105:317–323
Sarasquete ME, García-Sanz R, Armellini A, Fuertes M, Martín-Jiménez P, Sierra M, Del Chillón Carmen M, Alcoceba M, Balanzategui A, Ortega F, Hernández JM, Sureda A, Palomera L, González M, San Miguel JF (2006) The association of increased p14ARF/p16INK4a and p15INK4a gene expression with proliferative activity and the clinical course of multiple myeloma. Haematologica 91:1551–1554
Sawyer JR, Tricot G, Mattox S, Jagannath S, Barlogie B (1998) Jumping translocations of chromosome 1q in multiple myeloma: evidence for a mechanism involving decondensation of pericentromeric heterochromatin. Blood 91:1732–1741
Sawyer JR, Lukacs JL, Thomas EL, Swanson CM, Goosen LS, Sammartino G, Gilliland JC, Munshi NC, Tricot G, Shaughnessy JD Jr, Barlogie B (2001) Multicolour spectral karyotyping identifies new translocations and a recurring pathway for chromosome loss in multiple myeloma. Br J Haematol 112:167–174
Sawyer JR, Tricot G, Lukacs JL, Binz RL, Tian E, Barlogie B, Shaughnessy J Jr (2005) Genomic instability in multiple myeloma: evidence for jumping segmental duplications of chromosome arm 1q. Genes Chromosomes Cancer 42:95–106
Schilling G, Hansen T, Shimoni A, Zabelina T, Perez-Simon JA, Gutierrez NC, Bethge W, Liebisch P, Schwerdtfeger R, Bornhauser M, Otterstetter S, Penas EM, Dierlamm J, Ayuk F, Atanackovic D, Bacher U, Bokemeyer C, Zander A, San Miguel J, Nagler A, Kröger N (2008) Impact of genetic abnormalities on survival after allogeneic hematopoietic stem cell transplantation in multiple myeloma. Leukemia 22:1250–1255
Shaughnessy J Jr, Gabrea A, Qi Y, Brents L, Zhan F, Tian E, Sawyer J, Barlogie B, Bergsagel PL, Kuehl M (2001) Cyclin D3 at 6p21 is dysregulated by recurrent chromosomal translocations to immunoglobulin loci in multiple myeloma. Blood 98:217–223
Shaughnessy JD Jr, Zhan F, Burington BE, Huang Y, Colla S, Hanamura I, Stewart JP, Kordsmeier B, Randolph C, Williams DR, Xiao Y, Xu H, Epstein J, Anaissie E, Krishna SG, Cottler-Fox M, Hollmig K, Mohiuddin A, Pineda-Roman M, Tricot G, van Rhee F, Sawyer J, Alsayed Y, Walker R, Zangari M et al (2007) A validated gene expression model of high-risk multiple myeloma is defined by deregulated expression of genes mapping to chromosome 1. Blood 109:2276–2284
Smadja NV, Bastard C, Brigaudeau C, Leroux D, Fruchart C (2001) Hypodiploidy is a major prognostic factor in multiple myeloma. Blood 98:2229–2238
Tasaka T, Berenson J, Vescio R, Hirama T, Miller CW, Nagai M, Takahara J, Koeffler HP (1997) Analysis of the p16INK4A, p15INK4B and p18INK4C genes in multiple myeloma. Br J Haematol 96:98–102
Tiedemann RE, Gonzalez-Paz N, Kyle RA, Santana-Davila R, Price-Troska T, Van Wier SA, Chng WJ, Ketterling RP, Gertz MA, Henderson K, Greipp PR, Dispenzieri A, Lacy MQ, Rajkumar SV, Bergsagel PL, Stewart AK, Fonseca R (2008) Genetic aberrations and survival in plasma cell leukemia. Leukemia 22:1044–1052
Walker BA, Leone PE, Jenner MW, Li C, Gonzalez D, Johnson DC, Ross FM, Davies FE, Morgan GJ (2006) Integration of global SNP-based mapping and expression arrays reveals key regions, mechanisms, and genes important in the pathogenesis of multiple myeloma. Blood 108:1733–1743
Wuilleme S, Robillard N, Lodé L, Magrangeas F, Beris H, Harousseau JL, Proffitt J, Minvielle S, Avet-Loiseau H (2005) Ploidy, as detected by fluorescence in situ hybridization, defines different subgroups in multiple myeloma. Leukemia 19:275–278
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Dmoszyńska, A., Grząśko, N. (2012). Molecular Biology and Classification of Multiple Myeloma. In: Witt, M., Dawidowska, M., Szczepanski, T. (eds) Molecular Aspects of Hematologic Malignancies. Principles and Practice. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-29467-9_4
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