Myeloma Nurse Learning Programme Module 2 – Pathogenesis of myeloma Key points

Key points

  • Myeloma is a monoclonal B cell disorder that leads to abnormal proliferation of plasma cells
  • In myeloma and other plasma cell disorders, the abnormal proliferating plasma cell produces excess quantities of a specific but defective immunoglobulin
  • All immunoglobulins have a common basic structure of two identical heavy chain proteins and two identical light chain proteins, linked by chemical bonds
  • The type of heavy chain in an immunoglobulin determines its class
  • There are five classes of immunoglobulin, each playing a specific role in the immune response
  • The hallmark of myeloma is the secretion of a monoclonal immunoglobulin (paraprotein) by abnormal (myeloma) plasma cells
  • A small proportion of myeloma patients do not produce paraprotein or free light chains
  • Chromosomal abnormalities and mutations of key genes have been found in most cases of myeloma. These play a key part in the development and progression of the disease and have significant prognostic value
  • Other mechanisms e.g. epigenetic changes, can influence the development and progression of myeloma
  • IL-6 plays a pivotal role as a growth factor for myeloma cells
  • NF-κB is a cellular protein that induces gene transcription, resulting in the production of proteins that are important for myeloma cell growth and survival
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