Myeloma, amyloidosis, macroglobulinemia and other gammapathies

Problem

Multiple myeloma is due to an uncontrolled proliferation of plasma cells, bone-marrow cells that are responsible for generating antibodies and the proteins of which they are made. Growth of these cells leads to fractured bones, anemia, kidney failure, increased calcium in the blood, and infections.

Amyloidosis is also caused by the abnormal proliferation of plasma cells. In this case, however, the excess proteins are deposited in different organs, damaging them.

Treatments for these diseases include bone-marrow transplant and different drugs, such as proteasome inhibitors, immunomodulators, and monoclonal antibodies. Nevertheless, myeloma remains an incurable disease.

Approach

The group studies the mechanisms that cause people with asymptomatic or premalignant monoclonal gammopathies to develop myeloma, amyloidosis, or macroglobulinemia. It also evaluates the efficacy of new drugs.

Furthermore, it is researching immunotherapy treatments, which are based on modifying the patient’s immune system to control the disease. In this regard, CART therapy has been developed, which consists of reprogramming the patient’s lymphocytes to selectively attack only the malignant plasma cells.

Impact

The goal is to reduce or eliminate the signs and symptoms of myeloma, amyloidosis, and macroglobulinemia in the long term and even to cure some patients.

A strategy for achieving this is manipulation of the patient’s immune system so that it can control the growth of malignant plasma cells. Only a small proportion of patients with asymptomatic monoclonal gammopathies will develop a malignant gammopathy. Identifying these patients and understanding the mechanisms by which the disease progresses is therefore essential to increasing the efficacy of the treatments and achieving a cure.