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Blood, 1 July 2005, Vol. 106, No. 1, pp. 296-303.
Prepublished online as a Blood First Edition Paper on March 8, 2005; DOI 10.1182/blood-2005-01-0034.
Previous Article | Next Article 
Submitted January 6, 2005
Accepted February 27, 2005
Cyclin D dysregulation: an early and unifying pathogenic event in multiple myeloma
P L Bergsagel, W M Kuehl*, Fenghuang Zhan, Jeffrey Sawyer, Bart Barlogie, and John Shaughnessy, Jr
Comprehensive Cancer Center and Division of Hematology-Oncology, Mayo Clinic Scottsdale, Scottsdale, AZ, USA
Genetics Branch, National Cancer Institute, Bethesda, MD, USA
Donna D. and Donald M. Lambert Laboratory of Myeloma Genetics, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
Donna D. and Donald M. Lambert Laboratory of Myeloma Genetics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
* Corresponding author; email: wmk{at}helix.nih.gov.
Two oncogenic pathways have been hypothesized for multiple myeloma (MM) and pre-malignant MGUS tumors: a non-hyperdiploid pathway associated with a high prevalence of IgH translocations; and a hyperdiploid pathway associated with multiple trisomies of eight chromosomes. Cyclin D1, D2, or D3 expression appears to be increased and/or dysregulated in virtually all MM tumors despite their low proliferative capacity. Translocations can directly dysregulate CCND1 (11q13) or CCND3 (6p21), or MAF (16q23) or MAFB (20q11) transcription factors that target CCND2. Bi-allelic dysregulation of CCND1 occurs in nearly 40% of tumors, most of which are hyperdiploid. Other tumors express increased CCND2, either with or without a t(4;14) translocation. Using gene expression profiling to identify five recurrent translocations, specific trisomies, and expression of cyclin D genes, MM tumors can be divided into eight TC (translocation/cyclin D) groups - 11q13, 6p21, 4p16, maf, D1, D1+D2, D2, and NONE - that appear to be defined by early, and perhaps initiating, oncogenic events. However, despite subsequent progression events, these groups have differing gene expression profiles, and also significant differences in the prevalence of bone disease, frequency at relapse, and progression to extramedullary tumor.

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