Reconstructing the evolutionary history of multiple myeloma

Lay Summary

Understanding how cancer develops is key to manipulating it therapeutically. Here we describe how and when myeloma is initiated and the molecular processes by which it evolves 



Multiple myeloma is the second most common lymphoproliferative disorders, characterized by aberrant expansion of monoclonal plasma cells. In the last years, thanks to novel next generation sequencing technologies, multiple myeloma has emerged as one of the most complex hematological cancers, shaped over time by the activity of multiple mutational processes and by the acquisition of key driver events. In this review, we describe how whole genome sequencing is emerging as a key technology to decipher this complexity at every stage of myeloma development: precursors, diagnosis and relapsed/refractory. Defining the time windows when driver events are acquired improves our understanding of cancer etiology and paves the way for early diagnosis and ultimately prevention.

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