Abstract
Objective: Multiple Myeloma (MM) is a haematological disease resulting from the neoplastic transformation of plasma cells. The uncontrolled growth of plasma cells in the bone marrow and the delivery of several cytokines causes bone erosion that often does not regress, even in the event of disease remission. MM is characterised by a multi-step evolutionary path, which starts with an early asymptomatic stage defined as monoclonal gammopathy of undetermined significance (MGUS) evolving to overt disease. Data Sources and Study Selection: We have selected scientific publications on the specific topics “alarmis, MGUS, and MM”, drawing from PubMed. The keywords we used were alarmines, MGUS, MM, and immune system. Results: The analysis confirms the pivotal role of molecules such as high-mobility group box-1, heat shock proteins, and S100 proteins in the induction of neoangiogenesis, which represents a milestone in the negative evolution of MM as well as other haematological and non-haematological tumours. Conclusions: Modulation of the host immune system and the inhibition of neoangiogenesis may represent the therapeutic target for the treatment of MM that is capable of promoting better survival and reducing the risk of RRMM.
Highlights
Multiple Myeloma (MM) is a haematological disease resulting from the neoplastic transformation of plasma cells, which are the terminally differentiated cells of the B lymphocyte line [1,2]
MM is characterised by a multi-step evolutionary path, which starts with an early asymptomatic stage defined as monoclonal gammopathy of undetermined significance (MGUS) evolving to overt disease
It should be remembered that IL-1, IL-6, transforming growth factor (TGF)-β, and IL-23 favor the differentiation of Th17 cells, which have a widely demonstrated role in the etiology of autoimmune diseases and allergic diseases [78,79]
Summary
Multiple Myeloma (MM) is a haematological disease resulting from the neoplastic transformation of plasma cells, which are the terminally differentiated cells of the B lymphocyte line [1,2]. The uncontrolled growth of plasma cells in the bone marrow and the production of cytokines cause bone erosion, and the resulting bone lesions often do not regress, even in the event of disease remission. Plasma cell dysfunction and uncontrolled proliferation, granulocytopenia both from tumour marrow invasion and iatrogenic from chemotherapy, and high-dose administration of dexamethasone promote immunodeficiency in the patient with MM. Immunodeficiency favors both recurrent opportunistic infections and the evasion of the tumour from the immune response with its progression and wide spread [10,14,15,16,17]. Sci. 2021, 22, 9039 risk of rapid progression from MGUS to MM and whether they can be the target for future targeted therapies
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