http://jama.jamanetwork.com/ en-us Tue, 01 Mar 2011 00:00:00 GMT Tue, 01 Jan 2013 00:49:07 GMT Silverchair editor@jama.jamanetwork.com webmaster@jama.jamanetwork.com http://jama.jamanetwork.com/article.aspx?articleID=186982 Wed, 01 Dec 2010 00:00:00 GMT Landgren O, Waxman A. <span class="paragraphSection">Recent data indicate that multiple myeloma is consistently preceded by the precursor states of monoclonal gammopathy of undetermined significance (MGUS) and smoldering myeloma. Currently, multiple myeloma is a clinical diagnosis based on manifestations including hypercalcemia, renal failure, anemia, and bone lesions, whereas MGUS and smoldering myeloma are diagnosed based on laboratory abnormalities. Current clinical markers allow for more individualized risk stratification and counseling of these patients. However, there is a dearth of biomarkers and molecular imaging techniques capable of (1) accurately identifying patients with disease biology corresponding with high risk of progression; (2) elucidating the mechanism of transformation to multiple myeloma; and (3) forming a framework for development of targeted therapies. This case presentation and review discusses the current understanding of myeloma precursor disease and future opportunities for improving personalized management of patients with MGUS or smoldering myeloma, as well as the potential for developing early treatment strategies designed to delay and prevent development of multiple myeloma.</span> 304 21 2397 2404 10.1001/jama.2010.1713 http://jama.jamanetwork.com/article.aspx?articleID=186982 http://jama.jamanetwork.com/article.aspx?articleID=187000 Wed, 01 Dec 2010 00:00:00 GMT Pluta RM, Lynm C, Glass RM. <span class="paragraphSection">Multiple myeloma is a cancer of the bone marrow, also known as plasma cell myeloma or Kahler disease, after Dr Otto Kahler who described it in 1889. In multiple myeloma the bone marrow produces a subtype of white blood cells—plasma cells—that under normal conditions are responsible for production of antibodies (proteins that fight infections). These malignant plasma cells produce a paraprotein (an inactive antibody known also as M protein or Bence Jones protein) that adversely affects bone marrow, bones, blood, and the kidneys. Multiple myeloma is a somewhat uncommon disease that accounts for 1.1% of all cancers in white persons and 2% in elderly black persons and affects more men than women. For many years it has been known that multiple myeloma can have either a mild or very aggressive course. The December 1, 2010, issue of JAMA includes an article describing conditions that consistently precede the development of multiple myeloma.</span> 304 21 2430 2430 10.1001/jama.304.21.2430 http://jama.jamanetwork.com/article.aspx?articleID=187000