Leukaemia cytogenetics / H. Jackson Woodliff.

  • Woodliff, H. Jackson.
Date:
1971
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Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Leukaemia cytogenetics / H. Jackson Woodliff. Source: Wellcome Collection.

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    Chapter IX MYELOMA AND MACROGLOBULINAEMIA MYELOMA Introduction The term myeloma was introduced for localized tumours of the bone marrow and myelomatosis for the generalized condition with the neoplastic cells scattered throughout the bone marrow. It is now recognized that the cells are almost invariably plasmacytes, hence plasmacytoma and plasmacytomatosis are more apt; however, the earlier terms continue in general use. Solitary myelomas are uncommon and are usually found in the bone marrow but occasionally in other reticular tissues; multiple mye¬ loma or myelomatosis is more common, being widespread when the disease is first recognized. Reticular tissues other than the bone marrow may also be involved, abnormalities of the plasma proteins are present and frequently an abnormal protein (Bence Jones) is excreted in the urine. In the rare cases in which myeloma cells are present in the peripheral blood, the term plasma cell leukaemia is appropriate. In the present context, the word myeloma is used to include all these entities. Since it is allied to leukaemia, chromosome studies have been of interest and abnormalities have been found but not in all patients ; the findings and their significance are discussed here. Because the condition involves primarily bone marrow, this tissue is usually examined and may yield an abnormal karyotype even when the peripheral blood is normal. However, it must be remembered that many of the cells of the bone marrow may be normal normoblasts, myelocytes and megakaryocytic precursors, so that even if there is appreciable infiltration of myeloma cells abnormal karyotypes may be relatively few. Except in cases of plasma cell leukaemia normal cytogenetic findings might be expected in peripheral blood; in fact, abnormal karyotypes have been described even when they cannot be found in the bone marrow, possibly due to the presence of precursor myeloma cells in the circulation which are stimulated by PHA to divide in culture. Both peripheral blood and bone marrow should