The malignant plasma cells of multiple myeloma are derived from B cells, a type of white blood cell. These abnormal plasma cells are all alike because they have a common origin and are referred to as “monoclonal.”
Each patient’s myeloma cells share a common ancestry; they are all derived from a single B cell that has undergone cytogenetic changes.
Cytogenetic changes result in abnormalities in chromosome structures or numbers, which can be identified as molecular features. Because an individual patient’s myeloma cells all come from the same B cell, the specific cytogenetic changes from that B cell are preserved within the entire population of myeloma cells of that particular patient. Therefore, myeloma cells from an individual patient can be identified, characterized, and targeted based on their specific molecular features.
Researchers at the Myeloma Institute have pioneered in-depth analyses of the patterns and consequences of myeloma cell genetics. The result is an arsenal of powerful tools for developing individualized approaches to myeloma therapy. Several broad categories of cytogenetic changes are frequently observed in myeloma cells, and our long-term research has shown that certain categories of myeloma cells follow consistent disease trajectories and therapeutic responses. Therefore, detailed analyses of the chromosomes of a patient’s myeloma cells can help predict disease progression and guide treatment for that patient.
These detailed chromosomal analyses rely heavily on a technique called gene array analysis (also called gene expression profiling). Gene array analysis shows the activity of every gene in a patient’s myeloma cells at the same time — this is crucial to our approach of individualized therapy. The Myeloma Institute is the only facility in the world that routinely offers gene array analysis for newly referred patients and uses this information for patient management and planning of therapy.