Primer on medical genomics. Part IX: scientific and clinical applications of DNA microarrays--multiple myeloma as a disease model.

Multiple myeloma (MM) is a poorly understood and uniformly fatal malignancy of antibody-secreting plasma cells. Although several key molecular events in disease initiation or progression have been confirmed (eg, 14q32 translocations) or implicated (eg, chromosome 13 deletion), a unifying mechanism of myelomagenesis has eluded investigators. Furthermore, although MM is generally indistinguishable morphologically, it exhibits a tremendous degree of variability clinically with some patients surviving only months and others many years, suggesting that MM is composed of distinct clinical entities. Given that abnormal gene expression lies at the heart of most, if not all, cancers, high-throughput global gene expression profiling has become a powerful tool for investigating the molecular biology and clinical behavior of cancer. DNA microarray technology has facilitated the simultaneous quantification of thousands of cellular messenger RNAs (ie, gene expression). This review discusses progress made in the development of molecular-based diagnostics and prognostics for MM through the dissection of the transcriptome of plasma cells from healthy individuals and patients with MM and other plasma cell dyscrasias.