Multiple Myeloma and Related Disorders (Hodder Arnold Publication)

489 Pages·2004·10.99 MB·English

by  Gosta Gahrton

Multiple myeloma and
related disorders
Edited by
Gösta Gahrton MD PhD
Professor, Department of Medicine
Karolinska Institute, Huddinge University Hospital
Stockholm, Sweden
Brian G.M. Durie MD
Departments of Hematology and Oncology
Cedars-Sinai Medical Centre, Los Angeles, CA, USA
and
Diana M. Samson MD
Senior Lecturer in Haematology
Hammersmith Hospital, London, UK
A member ofthe Hodder Headline Group
LONDON
First published in Great Britain in 2004 by
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Contents
List of contributors v
Preface ix
List of abbreviations x
Notes on reference annotation xiv
The colour plate section appears between pages 338 and 339
PART 1 HISTORY AND EPIDEMIOLOGY 1
1 History of multiple myeloma 3
Robert A. Kyle and David P. Steensma
2 Epidemiology and etiology of plasma cell neoplasms 15
Daniel E. Bergsagel and P. Leif Bergsagel
PART 2 BIOLOGY AND PATHOPHYSIOLOGY 27
3 The immune system in myeloma 29
Douglas E. Joshua, P. Joy Ho, John Gibson and Ross D. Brown
4 Molecular biology and cytogenetics 46
Johannes Drach, Jutta Ackermann, Sonja Seidl and Hannes Kaufmann
5 Biology of the malignant plasma cell 58
Federico Caligaris-Cappio
6 Pathophysiology of myeloma bone disease 74
Babatunde O. Oyajobi and Gregory R. Mundy
PART 3 CLINICAL FEATURES, DIAGNOSIS, AND INVESTIGATION 89
7 Clinical features 91
Dietrich Peest
8 Hematologic investigations: morphologic and phenotypic features of myeloma marrow diagnosis 102
Thomas M. Grogan, Deborah Gelbspan and Lisa Rimsza
9 Biochemical and immunological investigations 125
Joanna M. Sheldon and Pamela G. Riches
10 The role of imaging in multiple myeloma 155
Brian G.M. Durie
11 Innovative approaches for diagnosis and monitoring 164
Faith E. Davies and Gareth J. Morgan
iv Contents
12 Multiple myeloma: differential diagnosis and prognosis 179
Jesús F. San Miguel and Ramón García-Sanz
PART 4 TREATMENT OF MYELOMA 201
13 Principles of management 203
Diana M. Samson
14 Chemotherapy, steroids, and interferon 220
Diana M. Samson
15 Radiotherapy
Deborah A. Frassica and Maria C. Jacobs 241
16 Autologous stem cell transplantation 250
Jean-Luc Harousseau and Michel Attal
17 Allogeneic transplantation and treatment with donor lymphocytes 260
Gösta Gahrton and Per Ljungman
18 Supportive care 275
Heinz Ludwig and Johannes Drach
19 Biological basis of therapy: new molecular targets 292
Terry H. Landowski and William S. Dalton
20 Immunotherapeutic approaches 305
Håkan Mellstedt
PART 5 COMPLICATIONS 317
21 Management of bone disease 319
Eugene V. McCloskey
22 Management of myeloma patients with renal failure 339
Joan Bladé and Laura Rosiñol
23 Neurologic aspects of monoclonal gammopathy of undetermined significance, 350
multiple myeloma, and related disorders
Robert A. Kyle and Angela Dispenzieri
PART 6 RELATED DISORDERS 367
24 Monoclonal gammopathies of undetermined significance: the transition from MGUS to myeloma 369
John A. Lust, Kathleen A. Donovan and Philip R. Greipp
25 Solitary bone and extramedullary plasmacytoma 379
Meletios A. Dimopoulos and Lia A. Moulopoulos
26 Plasma cell leukaemia 388
Xavier Leleu, Ibrahim Yakoub-Agha and Thierry Facon
27 AL amyloidosis 400
Raymond L. Comenzo
28 Heavy-chain diseases 420
Jean-Paul Fermand and Jean-Claude Brouet
29 Waldenström’s disease 429
Giampaolo Merlini and Steven P. Treon
Index 453
Contributors
Jutta Ackermann Meletios A. Dimopoulos MD
Department of Medicine I, Clinical Division of Oncology, Professor of Therapeutics, Department of Clinical Therapeutics,
University Hospital, Vienna, Austria University of Athens School of Medicine, Athens, Greece
Michel Attal Angela Dispenzieri MD
Head of Hematological Department, Hôpital Purpan, Toulouse, Consultant, Division of Hematology and Internal Medicine,
France Mayo Clinic; and Assistant Professor of Medicine, Mayo
Medical School, Rochester, MN, USA
Daniel E. Bergsagel CMMDDPhil
Professor of Medicine, University of Toronto, Department of
Kathleen A. Donovan PhD
Medicine, Ontario Cancer Institute/Princess Margaret Hospital,
Professional Associate in Research, Division of Hematology and
Toronto, Ontario, Canada
Internal Medicine, Mayo Clinic, Rochester, MN, USA
P. Leif Bergsagel MDFRCP(C)
Johannes Drach MD
Associate Professor of Medicine, Weill Medical College of
Department of Medicine I, Clinical Division of Oncology,
Cornell University, Department of Medicine, New York
University Hospital, Vienna, Austria
Presbyterian Hospital, New York, NY, USA
Joan Bladé MD Brian G.M. Durie MD
Department of Hematology, Institute of Hematology and Departments of Hematology and Oncology, Cedars-Sinai
Oncology, Postgraduate School of Hematology ‘Farreras Valentí’, Medical Centre, Los Angeles, CA, USA
Institut d’Investigacions Biomèdiques ‘August Pi i Sunyer’,
Thierry Facon MD
Hospital Clínic, University of Barcelona, Barcelona, Spain
Service des Maladies du Sang, Hôpital Claude Huriez, CHU,
Jean-Claude Brouet MDPhD Lille, France
Service d’Immunologie Clinique, Hôpital Saint-Louis, Paris, France
Jean-Paul Fermand MD
Ross D. Brown PhDMBAFAIMS Service d’Immunologie Clinique, Hôpital Saint-Louis, Paris,
Institute of Haematology, University of Sydney, Royal Prince France
Alfred Hospital, Camperdown, NSW, Australia
Deborah A. Frassica MD
Federico Caligaris-Cappio MD
Assistant Professor of Radiation Oncology, Department of
Professor of Internal Medicine, Università Vita Salute, Istituto
Radiation Oncology and Molecular Radiation Sciences, Sidney
Scientifico San Raffaele, Milan, Italy
Kimmel Comprehensive Cancer Center, Johns Hopkins
Raymond L. Comenzo MD University, Baltimore, MD, USA
Division of Hematologic Oncology, Department of Medicine,
Memorial Sloan-Kettering Cancer Center, New York, NY, USA Gösta Gahrton MDPhD
Professor, Department of Medicine, Karolinska Institute,
William S. Dalton PhDMD Huddinge University Hospital, Stockholm, Sweden
H Lee Moffitt Cancer Center and Research Institute, University
of South Florida, Tampa, FL, USA Ramón García-Sanz MDPhD
Department of Hematology, University Hospital of Salamanca,
Faith E. Davies MBBChMRCPMD Salamanca, Spain
Department of Health Clinician Scientist and Academic SpR,
Epidemiology and Genetics Unit, Academic Department of Deborah Gelbspan MD
Haematology and Oncology, School of Medicine, University of UMC, Department of Pathology, University of Arizona, Tucson,
Leeds, Leeds, UK AZ, USA
vi Contributors
John Gibson MBBSPhDFRACPFRCPA Håkan Mellstedt MDPhD
Institute of Haematology, University of Sydney, Royal Prince Professor of Oncologic Biotherapy, Karolinska Institute,
Alfred Hospital, Camperdown, NSW, Australia Managing Director, Cancer Centre Karolinska, Department of
Oncology and Hematology, Karolinska Hospital, Stockholm,
Philip R. Greipp MD
Sweden
Consultant, Division of Hematology and Internal Medicine,
Mayo Clinic, and Professor of Medicine, Mayo Medical School, Giampaolo Merlini MD
Rochester, MN, USA Professor of Clinical Biochemistry, Department of Biochemistry,
University of Pavia, and Biotechnology Research Laboratories,
Thomas M. Grogan MD
University Hospital Policlinico San Matteo, Pavia, Italy
UMC, Department of Pathology, University of Arizona,
Tucson, AZ, USA Gareth J. Morgan PhDFRCPFRCPath
Professor of Haematology, Epidemiology and Genetics Unit,
Jean-Luc Harousseau
Academic Unit of Haematology and Oncology, School of
Professor, Université de Nantes, Centre Hospitalier Régional,
Medicine, University of Leeds, Leeds, UK
Hôtel-Dieu, Département d’Hématologie, Nantes, France
P. Joy Ho MBBSDPhilFRACPFRCPA Lia A. Moulopoulos MD
Institute of Haematology, University of Sydney, Royal Prince Assistant Professor, Department of Radiology, University of
Alfred Hospital, Camperdown, NSW, Australia Athens School of Medicine, Athens, Greece
Maria C. Jacobs MD Gregory R. Mundy MD
Director, Department of Radiation Oncology, Mercy Medical Departments of Cellular and Structural Biology and
Center, Baltimore, MD, USA Orthopedics, University of Texas Health Science Center at San
Antonio, San Antonio Cancer Institute, San Antonio, TX, USA
Douglas E. Joshua BScMBBSDPhilFRACPFRCPA
Professor and Head of Institute of Haematology, University of Babatunde O. Oyajobi MDChBPhD
Sydney, Royal Prince Alfred Hospital, Camperdown, NSW, Australia Departments of Cellular and Structural Biology and Molecular
Medicine, University of Texas Health Science Center at San
Hannes Kaufmann MD
Antonio, San Antonio, TX, USA
Department of Medicine I, Clinical Division of Oncology,
University Hospital, Vienna, Austria Dietrich Peest MD
Professor of Medicine and Clinical Immunology, Department
Robert A. Kyle MD
of Hematology and Oncology, Hannover Medical School,
Consultant, Division of Hematology and Internal Medicine,
Hannover, Germany
Mayo Clinic; and Professor of Medicine and of Laboratory
Medicine, Mayo Medical School, Rochester, MN, USA Pamela G. Riches PhDFRCPath
Professor, Protein Reference Unit, Department of Biochemistry
Terry H. Landowski PhD
and Immunology, St George’s Hospital Medical School,
Research Assistant Professor, Department of Medicine, Arizona
London, UK
Cancer Center, University of Arizona, Tucson, AZ, USA
Xavier Leleu MD Lisa Rimsza MD
UMC, Department of Pathology, University of Arizona, Tucson,
Service des Maladies du Sang, Hôpital Claude Huriez, CHU,
AZ, USA
Lille, France
Per Ljungman MDPhD Laura Rosiñol MD
Department of Medicine, Karolinska Institute, Huddinge Department of Hematology, Institute of Hematology and
University Hospital, Stockholm, Sweden Oncology, University of Barcelona, Barcelona, Spain
Heinz Ludwig MD Diana M. Samson MD
Professor,Department of Medicine and Medical Oncology, Senior Lecturer in Haematology, Hammersmith Hospital,
Wilhelminenspital, Vienna, Austria London, UK
John A. Lust MDPhD Jesús F. San Miguel MDPhD
Consultant, Division of Hematology and Internal Medicine, Professor of Hematology, Department of
Mayo Clinic, and Associate Professor of Medicine, Mayo Hematology, University Hospital of Salamanca,
Medical School, Rochester, MN, USA Salamanca, Spain
Eugene V. McCloskey MBBChMRCPMD Sonja Seidl MD
WHO Collaborating Centre for Metabolic Bone Diseases, Department of Medicine I, Clinical Division of Oncology,
University of Sheffield Medical School, Sheffield, UK University Hospital, Vienna, Austria
Contributors vii
Joanna M. Sheldon PhDMRCPath Steven P. Treon MDMAPhD
Protein Reference Unit, Department of Biochemistry Director, Waldenstrom’s Macroglobulinemia Program, Dana
and Immunology, St George’s Hospital Medical School, Farber Cancer Institute, Instructor of Medicine, Harvard
London, UK University, Boston, MA, USA
David P. Steensma MD Ibrahim Yakoub-Agha MD
Fellow in Hematology, Mayo Graduate School of Medicine, Service des Maladies du Sang, Hôpital Claude Huriez, CHU,
Mayo Clinic, Rochester, MN, USA Lille, France
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Preface
Since the publication of our original book on multiple Very important progress has been made in stem-cell
myeloma in 1996,there has been an enormous increase transplantation and it is now confirmed in more than one
in knowledge about the disease:more than 5000 articles prospective study that high-dose therapy with autologous
have been published in scientific journals.The develop- transplantation is superior to conventional chemother-
ment has been impressive both in the basic knowledge apy for patients under 65 years of age. It also seems
about the disease and in its treatment. that tandem transplantation may be superior to single
New technologies have made it possible to refine stud- autologous transplantation, at least for subgroups of
ies on chromosomes and genes and to gain information patients.Interesting attempts are being made to decrease
about gene expression.Microarray is in its early stage,but the intensity of the conditioning regimen for allogeneic
already there have been pattern descriptions that may transplantation,and to utilize the immune effect of the
have prognostic implications. donor marrow and donor lymphocytes.
We have learned not only that deletions of chromo- These and other new developments, not only in
some 13 are important but also that chromosome 14 multiple myeloma, but also in related disorders, such as
translocations involving candidate oncogenes on other amyloid light-chain amyloidosis, heavy-chain disease,
chromosomes,such as Cyclin D1 or FGFR3,may be even and Waldenström’s macroglobulinemia, are described
more important in the pathogenesis of the disease.The in this new,expanded book.Each chapter area is able to
prognostic impact ofchromosomal abnormalities is now stand alone;thus,there is some deliberate overlap between
clearer than before, and the complicated interaction chapters.
between the stroma cells,the myeloma cells,and numer- With this approach,our hope is that the book will be
ous cytokines and their receptors has been better of interest not only for scientists and specialists in the
explained. Most importantly, attempts have been made field,but also for practitioners and non-specialists with
to utilize this new knowledge to develop targeted ther- an interest in basic aspects oftreatment ofpatients with
apy and,although results are still modest,improvements multiple myeloma.
have been obtained with thalidomide and analogs, as
Gösta Gahrton
well as with proteasome inhibitors,such as bortezomib.
Brian G.M.Durie
Many other approaches to targeted therapy are being
Diana M.Samson
attempted and are reviewed.