Plasma Cell Neoplasms

C90WHO Vol. 11 (2024)

Haematolymphoid System

Prognosis

This section is being prepared by our editorial process.

🔬 Histological Types

📚 Latest Research

2026-09-10

Patient-derived mesenchymal stromal cells establish an IL-6 axis that marks progression from smouldering to active multiple myeloma.

Blair PE, et al

Researchers have identified a paracrine IL-6 trans-signalling axis — in which bone marrow mesenchymal stromal cells (MSCs) supply the IL-6 ligand while multiple myeloma (MM) cells provide soluble IL-6 receptor (sIL-6R) — as a key mechanism driving progression from smouldering to active myeloma, with MM cells from active disease patients secreting substantially greater quantities of sIL-6R than those from smouldering disease patients, establishing sIL-6R as a marker of biologically active disease. MSCs in advanced disease also display higher basal IL-6 secretion, demonstrating augmentation of the entire pathway as disease progresses. Using Hyper-IL-6 and sgp130, the study showed that trans-signalling through gp130 is the dominant route by which stromal-derived IL-6 protects MM cells from treatment-induced apoptosis, independent of membrane-bound IL-6R expression. These findings propose that targeted inhibition of IL-6 trans-signalling with sgp130 could provide a more precise and potentially safer alternative to total IL-6/IL-6R blockade, and that early intervention in smouldering myeloma — before pathway amplification — may represent a more effective therapeutic strategy.

Cytokine

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2026-09-10

Treatment Decisions in Multiple Myeloma.

Mouhieddine TH, et al

A comprehensive review published in The New England Journal of Medicine presents a practical, evidence-anchored framework for navigating treatment decisions across the full spectrum of multiple myeloma, a plasma cell cancer transformed from a disease with survival measured in a few years into one for which functional cure is now an emerging goal. In newly diagnosed disease, quadruplet induction therapy is now considered standard of care, while the role of autologous stem-cell transplantation is being actively reevaluated in light of new data. For relapsed disease, the authors provide guidance on sequencing B-cell maturation antigen-directed CAR T-cell therapies, bispecific antibodies, and antibody-drug conjugates, with emphasis on preserving T-cell fitness and employing multiantigen targeting to counter exhaustion and antigen escape. Cytogenetic and genomic risk stratification, patient functional fitness, and measurable residual disease status are highlighted as the pillars of treatment individualization, alongside early interception strategies in high-risk smoldering myeloma.

The New England journal of medicine

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2026-09-08

Readmission in patients with hematologic malignancies: A systematic review and meta-analysis.

Yang M, et al

A meta-analysis of 104 studies found that hospital readmission rates among patients with hematologic malignancies are high across all follow-up windows, with 30-day rates of 26.67% for multiple myeloma, 22.20% for leukemia, and 13.67% for lymphoma among non-transplant patients. Among hematopoietic stem cell transplant (HSCT) recipients, pooled readmission rates escalated progressively from 23.93% within 30 days to 56.55% within one year, and the type of transplant significantly influenced rates at 30, 100, and 180 days and at one year (P = 0.033, 0.009, <0.0001, and <0.0001, respectively). The authors conclude that early readmissions likely reflect acute treatment-related complications, while longer-term patterns are additionally shaped by transplant-related morbidity, patient characteristics, and healthcare-system factors, highlighting an urgent need for targeted interventions in this high-risk population.

Leukemia research

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