chapter  29
18 Pages

Stem Cell Transplantation for Multiple Myeloma—10 Years Later

ByDavid S. Siegel, Seah H. Lim, Guido Tricot, K. R. Desikan, A. Fassas, Jayesh Mehta, Seema Singhal, Elias Anaissie, Sundar Jagannath, Barthel Barlogie

I. INTRODUCTION Multiple myeloma (MM) is the most aggressive member in the spectrum of diseases called plasma cell dyscrasias. It is characterized by the accumulation of large numbers of clonal, transformed plasma cells. Patients suffer from the consequences of (1) local tumor infiltration and destruction; (2) abnormal cytokine production with anemia, hypercalcemia, bone destruction, and suppression of normal immunoglobulin production; (3) monoclonal immunoglobulin production which can be associated with deposition diseases (light chain cast nephropathy, amyloid, light chain deposition disease), hyperviscosity, coagulopathies, and occasionally autoimmune phenomena; and (4) renal failure. In the United States, multiple myeloma occurs with a frequency of approximately 1% of all malignancies and 10% of all hematological malignancies. The median age at diagnosis is between 65 and 70 years (1).