Cancer Investigation, 8(5) 569 (1990)
EDIT0RIAL
Cancer Invest Downloaded from informahealthcare.com by University of Melbourne on 10/26/14 For personal use only.
Anaplastic Transformation of Multiple Myeloma Stanley L. Lee, M.D.
phenomenon in multiple myeloma, and showed that transformation to what they call the “aggressive terminal phase” is not rare, occurring in perhaps a third of patients. Although the clonal nature of immunoglobulin secretion in myeloma has stimulated tremendous advances in immunology within the past 20 years, the intracellular processes which lead to the development of an autonomous (malignant) clone of plasma cells have resisted analysis. Karyotypic and gene rearrangementanalyses of myeloma cells performed prospectively, in individual patients, as Allen and Coleman suggested, may be helpful in understanding not only what happens in myeloma, but also the mutational events which occur in all cancers.
Peter Nowell proposed in 1976 (l),that progression of an individual malignant tumor is governedby an “inherent acquired genetic variability within the original clone, allowing sequential selection of more aggressive sublines.” According to this model, the progressivelyaccelerating malignancy of any individual tumor occurs in stepwise fashion rather than continuously. The tumor which has best exemplified stepwise progression from an apparently benign to a highly malignant process has been chronic myelogenous leukemia, and it is in that disease that understanding of the chromosomal anatomy and the molecular biology of the actual mutations is farthest advanced. Clinical validation of Nowell’s thesis has been recogized as well in the transformation of adenomatous polyps of the colon to adenocarcinoma, in the evaluation of myelodysplastic syndromes to acute leukemia, and in the (occasional)progression of chronic lymphocytic leukemia to large cell lymphoma (Richter syndrome). In Cancer Investigation, Volume 8(3&4), Allen and Coleman (2) reviewed the literature on the analogous
REFERENCES 1. Nowell PC:The clonal evolution of tumor cell populations.Science 194~23-28, 1976. 2. Allen SL and Coleman M: Aggressive phase multiple myeloma: A terminal anaplastic transformation resembling high grade lymphoma. Cancer Invest 8:417-424, 1990.
569 Copyright 0 1990 by Marcel Jkkker, Inc.
EDIT0RIAL
Cancer Invest Downloaded from informahealthcare.com by University of Melbourne on 10/26/14 For personal use only.
Anaplastic Transformation of Multiple Myeloma Stanley L. Lee, M.D.
phenomenon in multiple myeloma, and showed that transformation to what they call the “aggressive terminal phase” is not rare, occurring in perhaps a third of patients. Although the clonal nature of immunoglobulin secretion in myeloma has stimulated tremendous advances in immunology within the past 20 years, the intracellular processes which lead to the development of an autonomous (malignant) clone of plasma cells have resisted analysis. Karyotypic and gene rearrangementanalyses of myeloma cells performed prospectively, in individual patients, as Allen and Coleman suggested, may be helpful in understanding not only what happens in myeloma, but also the mutational events which occur in all cancers.
Peter Nowell proposed in 1976 (l),that progression of an individual malignant tumor is governedby an “inherent acquired genetic variability within the original clone, allowing sequential selection of more aggressive sublines.” According to this model, the progressivelyaccelerating malignancy of any individual tumor occurs in stepwise fashion rather than continuously. The tumor which has best exemplified stepwise progression from an apparently benign to a highly malignant process has been chronic myelogenous leukemia, and it is in that disease that understanding of the chromosomal anatomy and the molecular biology of the actual mutations is farthest advanced. Clinical validation of Nowell’s thesis has been recogized as well in the transformation of adenomatous polyps of the colon to adenocarcinoma, in the evaluation of myelodysplastic syndromes to acute leukemia, and in the (occasional)progression of chronic lymphocytic leukemia to large cell lymphoma (Richter syndrome). In Cancer Investigation, Volume 8(3&4), Allen and Coleman (2) reviewed the literature on the analogous
REFERENCES 1. Nowell PC:The clonal evolution of tumor cell populations.Science 194~23-28, 1976. 2. Allen SL and Coleman M: Aggressive phase multiple myeloma: A terminal anaplastic transformation resembling high grade lymphoma. Cancer Invest 8:417-424, 1990.
569 Copyright 0 1990 by Marcel Jkkker, Inc.
