Friday, June 9, 2023
This activity is intended for hematologists, oncologists, internists, and other clinicians caring for patients with light-chain amyloidosis (AL) or multiple myeloma (MM).
The goal of this activity is to describe the differentiation stage of tumor plasma cells (ls) in patients with AL and MM and a transcriptional atlas of normal PC development (n = 11) in secondary lymphoid organs (SLOs), peripheral blood (PB), and bone marrow (BM) for comparison with the transcriptional programs (TPs) of tumor PCs in AL (n = 37), MM (n = 46), and monoclonal gammopathy of undetermined significance (MGUS) (n = 6).
Upon completion of this activity, participants will:
As an organization accredited by the ACCME, Medscape, LLC requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.
Medscape, LLC encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.
Medscape, LLC designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]
There are no fees for participating in or receiving credit for this online educational activity. For information on applicability
and acceptance of continuing education credit for this activity, please consult your professional licensing board.
This activity is designed to be completed within the time designated on the title page; physicians should claim only those
credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the
activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 75% on the post-test.
Follow these steps to earn CME/CE credit*:
You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it.
Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print
out the tally as well as the certificates from the CME/CE Tracker.
*The credit that you receive is based on your user profile.
CME / ABIM MOC Released: 10/28/2021
Valid for credit through: 10/28/2022
processing....
Although light-chain amyloidosis (AL) and multiple myeloma (MM) are characterized by tumor plasma cell (PC) expansion in bone marrow (BM), their clinical presentation differs. Previous attempts to identify unique pathogenic mechanisms behind such differences were unsuccessful, and no studies have investigated the differentiation stage of tumor PCs in patients with AL and MM. We sought to define a transcriptional atlas of normal PC development in secondary lymphoid organs (SLOs), peripheral blood (PB), and BM for comparison with the transcriptional programs (TPs) of tumor PCs in AL, MM, and monoclonal gammopathy of undetermined significance (MGUS). Based on bulk and single-cell RNA sequencing, we observed 13 TPs during transition of normal PCs throughout SLOs, PB, and BM. We further noted the following: CD39 outperforms CD19 to discriminate newborn from long-lived BM-PCs; tumor PCs expressed the most advantageous TPs of normal PC differentiation; AL shares greater similarity to SLO-PCs whereas MM is transcriptionally closer to PB-PCs and newborn BM-PCs; patients with AL and MM enriched in immature TPs had inferior survival; and protein N-linked glycosylation–related TPs are upregulated in AL. Collectively, we provide a novel resource to understand normal PC development and the transcriptional reorganization of AL and other monoclonal gammopathies.
Multiple myeloma (MM) and light-chain amyloidosis (AL) are the most common malignant monoclonal gammopathies. Although both present with accumulations of tumor plasma cells (PCs) in bone marrow (BM), AL results from the deposition of misfolded light chains.[1-3] This urged the identification of the unique pathogenic mechanisms in AL. Success in identifying these mechanisms has thus far been limited.[4-7]
Knowledge about the neoplastic transformation of normal PCs remains scarce,[8] particularly when considering the anatomical diversity reflected by their generation in secondary lymphoid organs (SLOs), circulation in peripheral blood (PB), and residence in BM. Thus, we sought to develop a gene-expression atlas of normal PC differentiation throughout SLOs, PB, and BM to compare transcriptional programs (TPs) expressed in tumor PCs of AL vs monoclonal gammopathy of undetermined significance (MGUS) and MM.
