Hello my name is Eline Menu.
I am from the Hematology and Immunology lab of the Free University of Brussels.
Today, I will talk to you about the role of exosomes
and multiple myeloma developments and drug resistance.
Multiple myeloma is an incurable plasma cell malignancy.
It's the second most common hematological malignancy
with an incidence of six people in a 100,000.
The average age of diagnosis is 65 years with an average survival of three to four years.
Multiple myeloma develops in the bone marrow.
There, the myeloma blown will expand and this will lead to the secretion of
a monoclonal immunoglobulin or M-spire
the induction of osteolysis and the induction of angiogenesis.
This altogether, will lead to the typical what we call CRAB
symptoms which stand for hyperCalcemia Renal failure,
Anemia and Bone lesions.
Myeloma patients will also have vague symptoms including fatigue and infections.
The diagnosis of multiple myeloma most
often occurs by measuring the M spike in serum or urine.
As you can see on the right,
this is an electrophoresis profile,
and in the far right corner you have gamma proteins there.
You can now see a peak.
Normally in healthy patients,
this is a more of a plateau because there are different kinds of immunoglobulins.
But with a myeloma patient,
there's one million clone secreting one type of immunoglobulin which causes the peak.
So the diagnostic criteria are 10% plasma cells in the bone marrow
and M spike of more than three grams per deciliter and at least one of the crap symptoms.
Myeloma is often preceded by a premalignant stage
called Monoclonal Gammopathy of Undetermined Significance or MGUS.
These patients have a detectable M spike,
but they do not have one of the CRABs symptoms,
and they have less than 10% plasma cells on a bone marrow smear.
However these patients are more closely monitored because they
can proceed to myeloma more often than a healthy person.