Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 98125 Messina, Italy.
National Research Council of Italy (CNR)-Institute of Applied Science and Intelligent System (ISASI), 98164 Messina, Italy.
Int J Mol Sci. 2019 Jun 10;20(11):2822. doi: 10.3390/ijms20112822.
Almost all multiple myeloma (MM) cases have been demonstrated to be linked to earlier monoclonal gammopathy of undetermined significance (MGUS). Nevertheless, there are no identified characteristics in the diagnosis of MGUS that have been helpful in differentiating subjects whose cancer may progress to a malignant situation. Regarding malignancy, the role of lymphocyte subsets and cytokines at the beginning of neoplastic diseases is now incontestable. In this review, we have concentrated our attention on the equilibrium between the diverse lymphocyte subsets and the cytokine system and summarized the current state of knowledge, providing an overview of the condition of the entire system in MGUS and MM. In an age where the therapy of neoplastic monoclonal gammopathies largely relies on drugs capable of acting on the immune system (immunomodulants, immunological checkpoint inhibitors, CAR-T), detailed knowledge of the the differences existing in benign and neoplastic forms of gammopathy is the main foundation for the adequate and optimal use of new drugs.
几乎所有多发性骨髓瘤 (MM) 病例都已被证明与早期意义未明的单克隆丙种球蛋白血症 (MGUS) 有关。然而,在 MGUS 的诊断中,没有发现有助于区分其癌症可能进展为恶性情况的特征。关于恶性肿瘤,淋巴细胞亚群和细胞因子在肿瘤性疾病开始时的作用现在是无可争议的。在这篇综述中,我们集中关注各种淋巴细胞亚群和细胞因子系统之间的平衡,并总结了目前的知识状态,概述了 MGUS 和 MM 中整个系统的状况。在肿瘤性单克隆丙种球蛋白病的治疗在很大程度上依赖于能够作用于免疫系统的药物(免疫调节剂、免疫检查点抑制剂、CAR-T)的时代,详细了解良性和肿瘤性丙种球蛋白形式之间存在的差异是充分和优化使用新药的主要基础。