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Hello, everybody. My name
is Professor Eline Menu.
I am from the translational
oncology research center
of the Vrije
Universiteit Brussel.
Specifically, I belong to
the hematology and
immunology team.
The topic of my talk
today is the role of
small extracellular vesicles in
multiple myeloma development
and drug resistance.
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Multiple myeloma is an incurable
plasma cell malignancy,
and it represents the
second most common
hematological malignancy
after non-Hodgkin's lymphoma.
The incidence is six
in 100000 people,
with an average age at
diagnosis of 65 years
and an average
survival of 6-7 years.
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Myeloma develops in
the bone marrow.
In the bone marrow,
one of the myeloma
clones will expand,
and this will lead
to a secretion of
a monoclonal
immunoglobulin or M-spike,
which you can see on the
graph on the right-hand side,
and this will also lead to
an induction of osteolysis
by creating an imbalance between
the osteoclasts and osteoblasts.
Those myeloma cells
will also induce
angiogenesis by activating
endothelial cells.
This leads to the
typical CRAB symptoms,
which stands for hypercalcemia,
because the bone is degraded,
and calcium is released
in the bloodstream.
Renal failure, because
the immunoglobulin
will clog the kidneys.
Anemia, and also
sensitivity to infections
because the white blood cells
are no longer produced
properly anymore.
And bone lesions because
of the osteolysis.
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The diagnosis often occurs
by measuring the M-spike
in serum or urine.
You can see an
electrophoresis figure
on the right-hand side.
The diagnostic criteria
are 10% plasma cells
on a bone marrow smear and
one of the
myeloma-defining events.
This can be either one
of the CRAB symptoms or
more than 60% plasma
cells in the bone marrow,
a serum-free light chain
ratio of more than 100,
and either one or
more focal lesions.
Myeloma is often preceded
by a premalignant stage
called monoclonal gammopathy of
undetermined
significance or MGUS.
In this case, the
M-spike is detectable,
but no CRAB symptoms
are present,
and there are fewer than 10%
plasma cells in the bone marrow.
These patients are not
treated but are monitored.
The therapies for
myeloma include
