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7 - Immune dysfunction in multiple myeloma

from Section 2 - Biological basis for targeted therapies in myeloma

Published online by Cambridge University Press:  18 December 2013

By
Guy Pratt  and
Paul Moss
Edited by
Stephen A. Schey ,
Kwee L. Yong ,
Robert Marcus  and
Kenneth C. Anderson
Stephen A. Schey
Affiliation:
Department of Haematology, King’s College Hospital, London
Kwee L. Yong
Affiliation:
Department of Haematology, University College Hospital, London
Robert Marcus
Affiliation:
Department of Haematology, King’s College Hospital, London
Kenneth C. Anderson
Affiliation:
Dana-Farber Cancer Institute, Boston
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Summary

Introduction

Immune dysfunction is an important feature of multiple myeloma and infection remains a major cause of morbidity and mortality. Numerous defects of the immune system occur in multiple myeloma and can also be observed in monoclonal gammopathy of uncertain significance. Indeed, evidence suggests that immune deficiency and infection may serve to promote progression to MM.

There has also been considerable interest in the identification of an autologous response against myeloma. Although cellular and humoral responses directed against myeloma-associated antigens have been described, it remains somewhat uncertain if the immune system plays a significant role in preventing or controlling myeloma cell growth. Despite this, there is an increasing interest in the potential role of immunotherapeutic approaches to treatment paraproteinemia although the immunologically hostile environment associated with multiple myeloma remains a major challenge.

An improved understanding of the mechanisms that mediate immune surveillance and tumor immunity in myeloma are important as a basis for improving patient outcome and are the subject of this review (Table 7.1).

Type
Chapter
Information
Myeloma
Pathology, Diagnosis, and Treatment
 , pp. 84 - 95
Publisher: Cambridge University Press
Print publication year: 2013

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