Stages of multiple myeloma

a repository of genetic changes that have accumulated during in vivo tumor progression, but also some additional genetic changes that have occurred during in vitro culture. As is true for cell lines from all malignancies, the incidence and type of genetic abnormalities in HMCL may not precisely reflect the in vivo tumor cells. Multiple myeloma is a low-prolifera-tive tumor. The plasma cell labeling index, typically detecting fewer than 1% of tumor cells actively synthesizing DNA until late in the disease, is a better prognostic indicator than the tumor cell content in the bone marrow.

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