Targeted Therapy and The Myeloma Cell

The picture to the right depicts the plasma cell with all the stuff hanging off it. The little "Y" shaped things are immunoglobulins (antibodies) composed of ameno acids which I referr to as "protein bullets." These are what create an immune response and tag a germ for disposal as depicted by the picture on the upper left. Some of the other hanging off structures take samples of germs in order to send a message to the plasma cell to create a unique immunoglobulin for this unique invader. Some of these hanging off structures are unique to the defective plasma cell which we call the myeloma cell (depicted below). Targeted therapy consists of a manufactured immunoglobulin which identifies the unique structures of the myeloma cell for myeloma cell destruction.

As you can see above, what we call a "cancer of the plasma cell", multiple myeloma is a genetic defect which causes a "defective" plasma cell to produce gobs of defective immunoglobulins or M-proteins. The myeloma cell is poorly formed with an irregular nucleus. If the myeloma cells are left untreated, the defective immunoglobulins which when normal are in relatively short supply when they reach the kidneys to be chopped up by enzymes and recycled as simple amino acids, arrive in mass which tends to overwhelm the kidney's ability to recycle and thus the defective immunoglobulins become lodged in the kidneys which leads eventually to renal failure and death.

The myeloma cells above are "secreting" m-protein. Some forms of myeloma are "non-secretory." Therefore, there are possibly as many variations of myeloma as there are people who have it. The thing that saves us treatment wise is that there are enough similarities to allow the cancer drugs to work on a number of minor variations. Targeted therapy should do a much better job of identifying myeloma cells and killing them since some of the targeted therapies use samples from individual patients in order to tailor the immunoglobulin for that specific myeloma cell deviant.