Adriena Sakalová, Mikuláš Hrubiško
During the last three decades the significant increase of malignant lymphoproliferative diseases, namely non-Hodgkin lymphomas (NHL) and multiple myeloma (MM) have appeared. The incidence of NHL is 13 -19.6/100 000 and of MM is 4-9/100 000 of population (in black twice as common, compared with the white; and slightly more common in males than in females). MM is the second most frequent haematological malignancy. Waldenström macroglobulinemia is contrary to the MM a rare disease with incidence 0.3/100 000 but the severity of disease is dangerous because of the risk of haemorrhagic complications, anaemia, infectious complications, and syndrome from hyperviscosity. For MM and WM the main characteristic is production of monoclonal immunoglobulin (paraprotein). In WM clonal lymphoplasmocytes produced IgM paraprotein, in the MM cells they produced paraprotein IgG, IgA and rare are IgM, IgD, IgE and light chain praprotein. MM and WM remain an incurable disease despite introduction of intensive therapies, but curable in early stage of disease. Recent molecular-genetic studies (sequencing of nucleotides in genome, mRNA profiling, etc.) demonstrate that various factors play an important role in the pathogenesis of these diseases (epigenetic microenvironment, cytokine, growth factors). This study also provides information about the new pathogenic aspects that revealed the risks of progression of monoclonal gammopathy of undetermined significance to WM, or to MM (symptomatic or asymptomatic form). This experience has led to molecular classification systems, to definition of new therapeutical strategies and better prognosis of these malignancies.