Cutting edge genomics reveal new insights into tumour development, disease progression and therapeutic impacts in multiple myeloma

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dc.contributor.authorDutta, A.
dc.contributor.authorHewett, D.
dc.contributor.authorFink, J.
dc.contributor.authorGrady, J.
dc.contributor.authorZannettino, A.
dc.date.issued2017
dc.description.abstractMultiple Myeloma (MM) is a haematological malignancy characterised by the clonal expansion of plasma cells (PCs) within the bone marrow. Despite advances in therapy, MM remains a largely incurable disease with a median survival of 6 years. In almost all cases, the development of MM is preceded by the benign PC condition Monoclonal Gammopathy of Undetermined Significance (MGUS). Recent studies show that the transformation of MGUS to MM is associated with complex genetic changes. Understanding how these changes contribute to evolution will present targets for clinical intervention. We discuss three models of MM evolution; the linear, the expansionist and the intraclonal heterogeneity models. Of particular interest is the intraclonal heterogeneity model. Here, distinct populations of MM PCs carry differing combinations of genetic mutations. Acquisition of additional mutations can contribute to subclonal lineages where "driver" mutations may influence selective pressure and dominance, and "passenger" mutations are neutral in their effects. Furthermore, studies show that clinical intervention introduces additional selective pressure on tumour cells and can influence subclone survival, leading to therapy resistance. This review discusses how Next Generation Sequencing approaches are revealing critical insights into the genetics of MM development, disease progression and treatment. MM disease progression will illuminate possible mechanisms underlying the tumour.
dc.description.statementofresponsibilityAnkit K. Dutta, Duncan R. Hewett, J. Lynn Fink, John P. Grady, and Andrew C.W. Zannettino
dc.identifier.citationBritish Journal of Haematology, 2017; 178(2):196-208
dc.identifier.doi10.1111/bjh.14649
dc.identifier.issn0007-1048
dc.identifier.issn1365-2141
dc.identifier.orcidZannettino, A. [0000-0002-6646-6167]
dc.identifier.urihttp://hdl.handle.net/2440/106967
dc.language.isoen
dc.publisherWiley
dc.relation.grantNHMRC
dc.rights© 2017 John Wiley & Sons Ltd
dc.source.urihttps://doi.org/10.1111/bjh.14649
dc.subjectMultiple myeloma; genomics; tumour evolution; intraclonal heterogeneity; clinical impacts
dc.titleCutting edge genomics reveal new insights into tumour development, disease progression and therapeutic impacts in multiple myeloma
dc.typeJournal article
pubs.publication-statusPublished

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