Multiple myeloma (MM) is a cancer of the bone marrow for which there is currently no known cure. The exact causes of multiple myeloma are not known, but it is more common in older people. It belongs to the group of “low-grade non-Hodgkin lymphomas” in which plasma cells grow in an uncontrolled and invasive manner. Plasma cells usually mature from B-lymphocytes and produce antibodies that are targeted against pathogens.

The degenerate plasma cells (so-called myeloma cells) produce large amounts of antibodies or antibody fragments that, however, have no function and are unable to fight infections. Their uncontrolled growth interrupts the maturation of healthy blood cells. The messenger substances of myeloma cells destroy bones, disturb the calcium balance and increase the likelihood of painful bone fractures.

The antibody fragments produced by the myeloma cells are often deposited in the kidneys causing kidney malfunctions. Signs and symptoms of the disease include bone destruction, limited kidney function, decreased numbers of red or white blood cells and frequent infections.

In Europe, multiple myeloma represents about ten per cent of all cases of leukaemia. According to Peter Liebisch, specialist for haematology and internal oncology in Ulm, multiple myeloma (plasmocytoma) makes up about one per cent of all malignant human diseases. Compared with other cancer diseases such as breast, intestinal or lung cancer, MM is a rare disease. In Europe, one in 100,000 people are affected annually.

The researchers in Ulm are aiming to deliver radioactive substances directly to the tumour cells in order to destroy them. The medical scientists are faced with two challenges: they need to distinguish the tumour cells from the healthy cells, while additionally delivering the radioactive substances directly to, or into, the tumour cells.

The research team has identified a group of tumour cells that are recognisable by an antigen on their surface. The radioactive substance is “attached” to a transporter (an antibody) that fits like a key into the lock of the antigen on the tumour cell. Once the tumour cell is identified with the aid of the key-lock principle, the radioactive substance destroys the cell.

Another system of transporters, the so-called nucleosides, consists of the same components as the human genome, thus enabling the direct delivery of the radioactive substance into the nucleus of the tumour cell.

The basic research of scientists in Ulm opens up new possibilities for the development of therapies for thus far incurable diseases. Agnieszka Morgenroth, Christoph Solbach and Sven Reske of the Department of Nuclear Medicine and Donald Bunjes and Peter Liebisch of the Department of Internal Medicine are involved in the project.

In 1988, the Spanish tenor José Carreras set up the José Carreras Leukaemia International Foundation after having recovered from leukaemia thanks to a stem cell transplant. The German José Carreras Leukaemia Foundation was founded in 1995. The foundation has thus far supported over 600 projects, including the funding of science and research, the financing of structural measures such as the construction of transplantation units, day hospitals or rehabilitation centres as well as support for self-help groups and parent initiatives.

Sources: Ulm University Hospital, Malignant Lymphomas Competence Network (wp, 19th June 2008, N)