“Multiple myeloma is a disorder in which malignant plasma cells accumulate in the bone marrow and produce an immunoglobulin…”. The result of the production of the immunoglobulin is a number of physical maladies which include: recurrent bacterial infections, anemia, and renal complications. Currently multiple myeloma is attributable to one percent of cancer death in the United States and further its epidemiology and cause are unknown. Given the complex nature of multiple myeloma, it only stands to reason that diagnosis and treatment of this disease is incredibly complicated.
In an attempt to assess the current methodologies being utilized by researchers to diagnosis this disease, a review of the three most prominent techniques, their advantages and their limitations is presented. It is hopped that by considering the techniques in tandem, some insight into which method proves most effectual for diagnosis will be garnered. Currently there are three techniques that can be utilized in the diagnosis of multiple myeloma: interphase cytogenetics, fluorescence in situ hybridization or FISH, and FISH with simultaneous immunoflurescence detection. Although each technique utilizes different protocols for diagnosis all are aimed at determining a potential epidemiology of the disease. Researchers believe that once the progress of the disease is uncovered a reliable specific and reliable method of treatment can then be devised.
Interphase cytogenetics was the first technique developed to diagnose multiple myeloma. Because the technique has been utilized for several years a number of research studies have been conducted utilizing the technique. The results of some of the more notable studies are summarize below:
- Sawyer, Waldron, Jagannath, et al report that cytogenetic studies found only 8 out of 45 chromosomal abnormalities in patients that had multiple myeloma.
- Lloveras, Sole, Florensa, et al. report that of all 54 patients utilized in their study, none presented with chromosomal abnormalities by conventional cytogenetics.
- Dubinsky, Amiel, Manor, et al report that most cytogenetic studies detected the same abnormalities that were seen utilizing fish, with the exception of 17p13 in 3 different patients.
- Smadja, Bastard, Brigaudeau, et al., report that in their cytogenetic studies found that current cytogenetic protocols proved problematic in determining chromosomal abnormalities.
In general the research concerning metaphase cytogenetic studies for the diagnosis of multiple myeloma seem to indicate that the technique is not only tedious but unreliable as well. Chromosomal abnormalities in p13 and p17 seem to provide some link to the development of the disease, yet cytogenetic proves highly ineffectual in detecting these abnormalities.