Molecular architecture of MM
EHA Learning Center. Walker B. Jun 10, 2016; 136623
Topic: 3Ec Plasma cell myeloma (Multiple myeloma)
Disclosure(s): Myeloma Institute/University of Arkansas for Medical Sciences
Dr. Brian Walker
Dr. Brian Walker

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Roman Hájek - Chair Introduction
This year, the education sections on multiple myeloma are covering the state of the art in three hot topics, namely molecular pathogenesis of MM, pathogenesis and imaging of bone disease, and new aspects of smoldering multiple myeloma. Recently, we learned a lot about increasing genomic complexity and instability during the course of the disease. In the first education chapter, Brian Walker is analyzing and highlighting downstream effect of primary events and importance of driving mutations. In the second education chapter, Evangelos Terpos summarizes most important changes of diagnostic tools for bone disease evaluation in multiple myeloma for practicing hematologists and/or oncologists. Also, several novel agents under clinical investigation are reviewed based on increasing understanding of multiple myeloma bone disease pathophysiology.
In the third education chapter, María-Victoria Mateos is reviewing available stratification risk models for smoldering multiple myeloma (SMM); some of them have already predicted 80% of probability of progression to multiple myeloma requiring therapy within 2 years. Discussion of early treatment strategy of SMM is ongoing based on first positive trials. Understanding key goal of such intervention is important - to prove that early intervention can not only prolong overall survival, but could even cure some patients. This will potentially change current conservative approach, ‘watch and wait strategy’ which is still preferred by many hematologists.

Learning Objectives of the article
- To understand the present concept of molecular architecture of MM.
- To understand the present concept of molecular pathogenesis of myeloma bone disease and to become acquainted with the diagnostic potential of modern imaging techniques.
- To review the different models for risk classification of SMM and the available evidence for early intervention in high risk SMM.

Learning Objectives of the presentation
After viewing this presentation the participant will be able to:
- Describe the main structural genetic changes in myeloma.
- Describe the mutational spectra of myeloma.
- Identify the prognostic genetic markers in myeloma.

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