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2016 ; 128
(13
): 1735-44
Nephropedia Template TP
gab.com Text
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Clonal selection and double-hit events involving tumor suppressor genes underlie
relapse in myeloma
#MMPMID27516441
Weinhold N
; Ashby C
; Rasche L
; Chavan SS
; Stein C
; Stephens OW
; Tytarenko R
; Bauer MA
; Meissner T
; Deshpande S
; Patel PH
; Buzder T
; Molnar G
; Peterson EA
; van Rhee F
; Zangari M
; Thanendrarajan S
; Schinke C
; Tian E
; Epstein J
; Barlogie B
; Davies FE
; Heuck CJ
; Walker BA
; Morgan GJ
Blood
2016[Sep]; 128
(13
): 1735-44
PMID27516441
show ga
To elucidate the mechanisms underlying relapse from chemotherapy in multiple
myeloma, we performed a longitudinal study of 33 patients entered into Total
Therapy protocols investigating them using gene expression profiling,
high-resolution copy number arrays, and whole-exome sequencing. The study
illustrates the mechanistic importance of acquired mutations in known myeloma
driver genes and the critical nature of biallelic inactivation events affecting
tumor suppressor genes, especially TP53, the end result being resistance to
apoptosis and increased proliferation rates, which drive relapse by
Darwinian-type clonal evolution. The number of copy number aberration changes and
biallelic inactivation of tumor suppressor genes was increased in GEP70 high
risk, consistent with genomic instability being a key feature of high risk. In
conclusion, the study highlights the impact of acquired genetic events, which
enhance the evolutionary fitness level of myeloma-propagating cells to survive
multiagent chemotherapy and to result in relapse.