Switch translocationsimplication for pathogenesis

Thirty to fifty percent of multiple myeloma is preceded by MGUS. As indicated earlier, the incidence of the chromosome 14q23 translocation increases from 47% in MGUS, to 60% in intramedullary myeloma and 70-80% in plasma cell leukemia.35 38 It occurs in the premalignant stage (MGUS) and is stable within the myeloma population of each tumor. It is proposed to be the primary translocation that initiates oncogenesis.57 Conversely, changes such as complex c-myc translocations that do not occur in MGUS and tend to be heterogeneous within tumors are probably secondary/late events that contribute to disease progression.

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