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22. Abadie JM, Bankson DD. Assessment of serum free light chain assays for plasma cell disorder screening in a veterans affairs population. Ann Clin Lab Sci. 2006;36:157–62. 23. Nowrousian MR, Brandhorst D, Sammet C, Kellert M, Daniels R, Schiett P, Poser M, Mueller S, Ebeling P, Welt A, Bradwell AR, Buttkereit U, Opalka B, Flasshove M, Moritz T, Seeber S. Serum free light chain analysis and urine immunofixation electrophoresis in patients with multiple myeloma. Clin Cancer Res. 2005;11(24):8706–14.
Hence, increased MYC expression seems to be responsible for progression from MGUS to MM. Complex translocations involving MYC (c-MYC≫N-MYC>L-MYC) appear to be secondary progression events that often do not involve Ig loci [32]. They are rare or absent in MGUS, but occur in 15 % of newly diagnosed tumors, 50 % of advanced tumors, and 90 % of HMCLs [11, 33]. A recent report suggests that a small molecule inhibitor of BRD4 can inhibit MYC RNA expression in MM, with therapeutic effect [34]. , in t(11;14) tumors) [35].
5) [43] and most likely contributing to extramedullary spread of the disease. Interestingly, the NFKB negative regulator TRAF3 located on 14q32 is inactivated in >10 % MM tumors, suggesting that at least in the presence of RAS/BRAF compensating mutation there may be an advantage for t(4;14) MM to lose the der(14) containing FGFR3 in favor of activating the NFKB pathway. Fc, IKKβ, and NIK (MAP3K14)) are being developed as potential therapeutic agents [47, 48]. There is also some evidence suggesting that cells addicted to constitutive NFKB activation may be particularly sensitive to proteasome inhibition [46].