Multiple Myeloma—Biology, Diagnosis, Treatment and Prognosis (2nd Edition)

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 621

Special Issue Editor


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Guest Editor
Hematology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90128 Palermo, Italy
Interests: multiple myeloma; tumor immunology; T cell response; immunotherapy; chronic lymphocytic leukemia; monoclonal gammopathy; amyloidosis; CAR-T
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Special Issue Information

Dear Colleagues,

This Special Issue is the second edition of the Special Issue “Multiple Myeloma—Biology, Diagnosis, Treatment and Prognosis, which published 7 papers that have been viewed by 6126 scholars. 

In the recent two years since the reveal of the past Special Issue, many advances have been reached in the field of multiple myeloma, from the introduction of new drugs in clinical practice to the improved understanding of disease biology. Based on these developments, we have decided to launch a second edition to capture and highlight the latest progress in the field. Below is the call from the previous one, which reflects the ongoing vision and goals of this project:

Advancements in the deep understanding of multiple myeloma (MM) biology, coupled with the development of novel diagnostic tools and evermore effective drugs, have opened the way to the tremendous revolution we are experiencing in the management of patients with MM. Indeed, survival rates have significantly improved in recent years, with a current median life expectancy (since diagnosis) exceeding 10 years. Innovative approaches significantly impacted many areas of MM research and clinical practice, and many others are ready to “translate” from the bench to bedside. Along the same line, many new technologies are now ready to reach our “ordinary” work and will produce profound changes in our patient–management workflow. These effects are more visible in specific fields of MM research: MM biology was recently “shocked”  by the introduction of single-cell technologies (RNAseq, ATACseq, CITEseq, multiparametric spectral and traditional flow cytometry), which helped to characterize the microenvironment as well as the transcriptome of MM cells at an unprecedent detail level. The diagnostics of MM are facing the introduction of mass spectrometry for the detection of MM components, as well as the development of improved imaging strategies for the study of bone marrow involvement. Innovative immunotherapeutic agents, including CAR-T and bispecific agents, are finally ready to enter current clinical practice, and their correct positioning is still a matter of important debates (Will there still be a role for autologous stem cell transplant? Are there new mechanisms of resistance?). The achievement and maintenance of undetectable minimal residual disease (MRD) status is considered the most important prognostic factor for patients with MM, but is there still room for improvements? Could we use MRD for treatment guidance?

As an additional point, MM develops from premalignant conditions such as MGUS and smoldering MM. However, what are the key factors that drive disease progression? Can we identify specific populations at higher risk of developing plasma cell dyscrasias?

On these bases, this Special Issue aims to provide an overview of the current advances in the field of biology, innovative diagnostic and prognostic approaches (including immunomonitoring and MRD detection), and the development of novel treatment strategies for patients with MM.

We are pleased to invite you to submit original research articles and reviews focusing on the biology/pathology, diagnosis, treatment and prognosis of MM. Topics related to basic, clinical and translational research are welcome.

I look forward to receiving your contributions.

Dr. Cirino Botta
Guest Editor

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Keywords

  • multiple myeloma
  • bone marrow microenvironment
  • minimal residual disease
  • mass spectrometry
  • flow cytometry
  • CAR-T
  • bispecific agents
  • genomic alterations

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Published Papers (1 paper)

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13 pages, 844 KiB  
Systematic Review
Unveiling Extramedullary Myeloma Immune Microenvironment: A Systematic Review
by Kassiani Boulogeorgou, Maria Papaioannou, Sofia Chatzileontiadou, Elisavet Georgiou, Amalia Fola, Sofia-Eleni Tzorakoleftheraki, Evdoxia Hatjiharissi and Triantafyllia Koletsa
Cancers 2025, 17(7), 1081; https://doi.org/10.3390/cancers17071081 - 24 Mar 2025
Viewed by 448
Abstract
Background/Objectives: In recent years, efforts by the scientific community to elucidate the underlying mechanisms of clonal expansion and selection within tumors have led to the theory of “tumor ecosystems”, implicating, among other factors, the role of the microenvironment in therapy resistance and tumor [...] Read more.
Background/Objectives: In recent years, efforts by the scientific community to elucidate the underlying mechanisms of clonal expansion and selection within tumors have led to the theory of “tumor ecosystems”, implicating, among other factors, the role of the microenvironment in therapy resistance and tumor progression. In this context, the contribution of the microenvironment in the development of multiple myeloma (MM) is being investigated, imparting great emphasis on continuous clonal evolution. This process gives rise to aggressive clones with the potential to spread to extramedullary sites, rendering any treatment strategy practically ineffective. This systematic review aimed to gather knowledge about the immune microenvironment (IME) of extramedullary plasma cell myeloma and the differences in immune synthesis between medullary and extramedullary disease (EMD). Methods: A search strategy according to PRISMA guidelines was conducted in seven databases, and six articles meeting the inclusion criteria were encompassed in the study. Results: Results obtained from molecular analysis as well as flow cytometry and immunofluorescence indicated profound genetic instability at EMD sites along with spatial and temporal heterogeneity of the IME, implying a possible correlation between them. Both genetic and microenvironment variability were notably greater in EMD compared to medullary disease. The establishment of an immunosuppressive microenvironment was the rule, with exhausted CD8+ and natural killer (NK) cells, M2 macrophages, and inactivated dendritic cells found co-localized with neoplastic plasma cells, whereas cytotoxic CD8+ cells, M1 macrophages, and active dendritic cells congregated in tumor-free areas. Post-therapy alterations in the immune milieu were also noted and were concerned mostly the percentages of Tregs and MDSCs. Conclusions: The recognition of the microenvironment-myeloma cell interplay is essential for designing specific therapeutic strategies and ameliorating disease prognosis. Full article
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