Properties of T Regulatory Cells in Mutiple Myeloma

Multiple myeloma (also plasma cell myeloma also known as MM, myeloma, plasma cell myeloma, or as Kahler's disease) is a progressive hematologic (blood) disease. It is a cancer of the plasma cell, an important part of the immune system that produces immunoglobulins (antibodies) to help fight infection and disease.

Multiple Myeloma is a form of cancer which affects the plasma cells of the body, which are white blood cells. Multiple Myeloma, first described in 1848, is a disease “characterized by a proliferation of malignant plasma cells and a subsequent overabundance of monoclonal paraprotein.” To understand how Multiple Myeloma affects an infected person’s plasma cells, it helps to have a general understanding of how normal blood cells are formed and how they act. Most blood cells develop from stem cells, which can be found in bone marrow (soft material inside our bones – the “filling”). Stem cells mature into white blood cells, red blood cells, or platelets.2 The purpose of white blood cells is to fight off infection, while

The immaturity of the data is underscored by the disposition at the time of analysis. Patients were more likely to have discontinued based on adverse events than to have had disease progress or be continuing therapy. Although tolerability looked better when only patients receiving tremelimumab 1 mg were analyzed, even in that group, 30% of patients had a related grade > 3 adverse event, with 16% of patients discontinuing due to an adverse event and 4% dying from the study therapy. For comparison, in the studies that led to approval of pembrolizumab and nivolumab, grade > 3 related adverse events were seen in 7-10.5%, adverse events led to discontinuation of study therapy in 0.2-3.8% and death was related to study treatment in 0-0.3%.2, 3, 4

Leukemia broadly describes conditions that affect erythropoiesis in the bone marrow, lymphatic system, and spleen. As with all other cancers, leukemia begins from the mutation of DNA in certain cells. Classifications of leukemias are based on the age of onset and the leukocyte involved (Lewis et al. 2014, 665). The most common leukemia is chronic lymphocytic leukemia (CLL), accounting for approximately 30% of cases in the United States (Copstead and Banasik 2013, 222). The normal function of the bone marrow, spleen, and liver becomes interrupted by the invasion of malignant lymphocytes (B cells); since the B cells are functionally inactive, a patient becomes more susceptible to infections. The sluggish progression of CLL unfortunately leads to late diagnoses and poor prognosis (Lewis et al. 2014, 665). Patients that become symptomatic in later stages will experience fatigue, weight loss, anorexia, and an increased susceptibility to infection, due to abnormal antibody production. Patient specific factors such as age, disease progression, and medication side effects will determine the course of treatment (Copstead and Banasik 2013, 223). The fragile state of patients with CLL requires continuous examination of drug therapy and interventions to prevent further complications.

Multiple myeloma (MM) is a rare life-threatening cancer that affects the white blood cells known as plasma cells that are found in the soft, spongy tissue at the center of the bones, called bone marrow. The plasma cells are useful in fighting infections by producing antibodies that recognize and attack germs. The plasma cells are transformed into malignant myeloma cells when there are high levels of M proteins or better known as the production of abnormal antibodies from a result of myeloma cells. These M proteins multiple and block out normally functioning antibodies and the end results are bone damage or kidney problems. An individual can have blood tests or urine tests done to determine if they have multiple myeloma. In the article, “The work of living with a rare cancer: multiple myeloma” the authors explain how this type of cancer still remains incurable, but treatable that patients can expect to live longer, approximately five to seven years than what two decades ago. This was not expected for patients diagnosed with multiple myeloma during the 1990s, since patients were expected to only live about two and a half years after being diagnosed. Treatment for multiple myeloma throughout the years has advanced greatly yet a cure is still to be discovered. This essay will focus of the causes, the sign and symptoms, how multiple myeloma is detected and diagnosed, and how multiple myeloma is treated.

Multiple myeloma symptoms may vary by patients, with the early stages of myeloma often presenting no visible symptoms or signs. When present, the symptoms of multiple myeloma may be vague or similar to those of the other conditions. Certain multiple myeloma symptoms may also be associated with complications of the disease. Remember that not all individuals with myeloma will have symptoms and that is unusual for any one individual to have all of these symptoms. In addition, advances in treatment options allow for multiple myeloma symptoms to be managed or prevented. Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and spread to other areas of the body. To learn more about how cancer start and spread see what is cancer? Multiple Myeloma is a cancer formed by malignant plasma cells. Normal plasma cells are found in the bone marrow and are an important part of the immune system. The immune system is made up of several types of cells that works together to fight infections and other disease. Lymphocytes (lymph cells) are the main cell type of the immune system. The major types of lymphocytes are T cells and B cells. When B cells respond to an infection, they mature and change into plasma cells. Plasma cells

Multiple Myeloma is a neoplastic disease that involves the plasma cells within bone marrow. Plasma cells are a type of white blood cell that helps make up our immune system. They work within our immune system by generating antibodies that guard us from microorganisms and other unsafe materials. Although multiple myeloma forms in the immune system, the abnormal antibodies decrease the effectiveness of the body ability to fight infection. Since multiple myeloma is an uncommon cancer, the etiology is idiopathic, unknown. When plasma cells start to divide rapidly they become abnormal, and this is when myeloma starts. Healthy patients have a 5%

What if patients that suffer from Multiple Myeloma could finally have a treatment opinion with the aid of the immunology hormone, Thymosin ß-4? This hematologic (blood) disease has no cure at this specific time, but there are some factors that increase the susceptibility of contracting this disease. The factors include being over the age of 65, hereditary disposition and race also, people that already suffer a blood disease will probably contract MM. Why is trying to treat MM so important? Multiple Myeloma is stated as a cancer that is formed in a specific type of white blood cell (plasma cells). The main role of plasma cells is to secrete antibody that recognizes and attacks germs. These malignant plasma cells result in an increase of immunoglobulin components, most commonly IgG. This up regulation of IgG can ultimately cause kidney problems. To fully understand how this hormone may help patients that suffer from this disease first, I want to look at how the immune system interacts with hormones. Then, discuss what Thymosin ß-4 is and the effects on the inhibition of MM.

Multiple myeloma is blood cancer that starts in the plasma cells in bone marrow. Plasma cells are white blood cells that help your body fight infection by producing proteins called antibodies. When plasma cells grow out of control in the bone marrow, they no longer perform their intended function in the immune system, they form tumors in the areas of solid bone, and the growth of these bone tumors makes it harder for the bone marrow to make healthy blood cells and platelets. Multiple Myeloma is the second most common blood cancer in the United States and constitutes approximately 1 percent of all cancers. The age-adjusted death rate was 3.4 per 100,000 men and women per year, based on patients who died in 2005-2009 in the US. A plasmacytoma is tumor formed by a collection of aberrant plasma cells in a single location. Plasmacytomas may be an indication or precursor for multiple myeloma. This paper presents some highlights of the current approach for evaluating and treating plasmacytomas. I am writing about this problem because my father encountered a rare form of plasmacytoma last year that fortunately turned out to be an isolated occurrence with no indication of systemic disease.

Multiple myeloma (MM) is characterized by neoplastic proliferation of immunoglobulin-producing plasma cells. Many malignancies can mimic MM, however the concomitant existence of another primary malignancy alongside MM is exceedingly rare. We report the first case wherein MM and esophageal adenocarcinoma manifest concomitantly.

Multiple myeloma is a haematological malignancy characterised by the suppression of osteoblastogenesis and the inability to form bone8. The inhibition of the Runt-related transcription factor 2 (Runx2) which is a key transcription factor responsible for osteoblast differentiation is largely implicated in multiple myeloma4. Runx2 stimulates the generation of the bone formation markers alkaline phosphatase (ALP), osteocalcin (OCN) and collagen during early osteoblast differentiation9,10. Transgenic mice without the Runx2 gene exhibit a lack of osteoblast formation causing the arrest of both endochondral and intramembranous ossification11. The upregulation of bone resorption and a decrease in bone mass is a common feature of multiple myeloma, presenting clinically as lytic bone lesions12.

Patients with standard-risk myeloma have a median overall survival (OS) of 6–7 years while those with high-risk disease have a median OS of less than 2–3 years despite tandem autologous stem cell

PD-1 is a checkpoint protein on immune cells called T cells. It normally acts as a type of “off switch” that helps keep the T cells from attacking other cells in the body. It does this when it attaches to PD-L1, a protein on some normal (and cancer) cells. When PD-1 binds to PD-L1, it basically tells the T cell to leave the other cell alone. Some cancer cells have large amounts of PD-L1, which helps them evade immune attack. CTLA-4 is another protein on some T cells that acts as a type of “off switch” to keep the immune system in check. These two proteins are major target for anti-tumour mAbs under development.

It has been found that the anti-tumor response depends on the presentation of tumor antigens by dendritic cells. Tumor cells are poor antigen presenting cells and thus fail to elicit a potent anti-tumor immune response. Tumors can also prevent antigen presentation by a variety of mechanisms. Tumors can cause monocytes to differentiate to macrophages rather than dendritic cells and thus prevents the priming of tumor-specific T cells by dendritic cells. Tumors-derived factors can also alter the maturation of dendritic cells and cause a switch in DCs to become pro-tumorigenic. Another mechanism by which tumors evade stimulation of an anti-tumor immune response is by production of IL-10 which inhibits the DCs maturation.

In the battle against cancer, there are three critical components. Prevention, early diagnosis and treatment. Oncology incorporates these three elements to ensure that they can detect and be one step ahead in this fight. Cancer is associated with the immune suppression of the host. CTLA-4(cytotoxic T-lymphocyte-associated protein 4) also known as CD152 (cluster of differentiation 152), is a protein receptor that functioning as an immune checkpoint, ward off the immune system. CTLA-4 ensure that the T cells are not able to recognize and eliminate foreign antigens and thus, most often tumour cells can evade immune recognition and destruction (Oudard, 2013). The study will focus on the role of hematology and oncology in CTLA treatment, the role of CTLA treatment in graft survival and its role in autoimmune diseases.