Glossary

A
Albumin	Major protein found in the blood that is measured to provide some indication of health and nutritional status. Albumin levels are a measure used for staging myeloma and monitoring the disease.
Alkylating agent	A chemotherapy agent such as melphalan or cyclophosphamide. These agents cross –link the DNA of myeloma cells and block cell division.
Allergy	Hypersensitivity disease, often to the type of antigen that causes the disease such as food allergy, penicillin allergy and bee sting allergy. All of these conditions are related to the antigen-induced mast cell and basophil activation.
Analgesic	Pain relieving medication; Tylenol and Aspirin are mild analgesics.
Analogue	A slightly altered chemical structure of a parent compound. Revlimid is an analogue of Thalidomide.
Anemia	A decrease in the number of red blood cells in the blood.
Antibody	Protein produced by plasma cells that protects the body from infection and disease. Also called immunoglobulin (Ig).
Anticoagulant	Substance that stops blood from forming clots.
Antigen	Any foreign substance (such bacteria, viruses, toxins or cancer cells) that is found in the body that stimulate the immune system to produce antibodies to fight them.
B
B cell or B lymphocyte	The only white blood cell that produces antibodies, then positons them at the cell surface or secretes them as weapons in immune response.
Basophil	Fast acting white blood cell that secretes histamine and other substances during inflammation; may contribute to the allergy response. Basophil counts increase during the healing process; with an increase in corticosteroids eg. use of dexamethasone or prednisone the basophil count will decrease.
Benign	Not cancerous; does not invade nearby tissue or spread to other parts of the body.
Beta 2 microglobulin	A protein normally found on the surface of various cells in the body. High levels occur in inflammatory conditions and active myeloma. One of the blood tests used for monitoring myeloma and is the basis of a three class staging system for myeloma, known as the International Staging System. About 10% of myeloma patients do not produce B2M.
Bisphosphonate	Type of drug used to treat osteoporosis and bone disease related to cancer. Bisphosphonates work by inhibiting the activity of osteoclasts, cells that dissolve bone tissue.
Blood cells	Cells produced in the bone marrow; they include white blood cells, red blood cells and platelets.
Blood count	The number of white blood cells, red blood cells and platelets in a blood sample.
Bone marrow	The central cavity of bone where all circulating blood cells in the adult are made, including immature lymphocytes and is the site of B cell maturation. Found in the long bones of the thighs, ribs, arms, shoulders, pelvis, skull.
C
Calcium	A mineral important in bone formation. Elevated blood levels may occur when there is bone destruction due to myeloma.
Cancer	Cancer (medical term: malignant neoplasm) is a class of diseases in which a group of cells display uncontrolled growth (division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood).
Carcinogen	Any substance or agent that can trigger cancer.
Chemotherapy	The use of drugs to kill rapidly dividing cancer cells.
Chromosome	A DNA molecule with a thread-like structure in the living cell that contains genetic information; normal human cells contain 46 chromosomes.
Clinical trial	A research study of new treatment that involves patients. Each study is designed to find better ways to prevent, detect, diagnose or treat cancer and to answer scientific questions.
Complete Blood Count (CBC)	Blood test that measures the number of white blood cells, red blood cells, including the different type of cells that make up the white blood cell and red blood cell groups, and platelets.
Corticosteroids	A potent class of drugs that have anti-inflammatory, immunosuppressive and antitumor effects such as prednisone and dexamethasone.
Creatinine	A by-product of muscle metabolism that is normally filtered by the kidneys and excreted in the urine. Elevated levels in the blood can be an indicator of poor kidney function.
Cytokine	Secreted proteins that act as mediators of immune and inflammatory reactions. In innate immune responses, cytokines are produced by macrophages and natural killer cells and, in adaptive immune responses mainly by T lymphocytes.
D
Dendritic cells	Starfish-shaped “eater” white blood cell which when activated by battle signals, travels to the secondary lymph organs to display parts of the enemy it has engulfed to new T cells. Sort of like saying to these immune cells: “ hi guys – this is what we are looking for”.
Diagnosis	The process of identifying a disease by its signs and symptoms.
DNA	The substance of heredity; a large molecule that carries the genetic information that cells need to replicate and to produce proteins.
Drug resistance	The result of cells’ ability to resist the effects of a specific drug.
E
Electrophoresis	Laboratory test used to measure levels of various proteins in the blood or urine. Uses an electrical current to sort out the proteins. High levels of abnormal protein may show up as a spike. A test to used to diagnose myeloma and monitor the disease.
Enzyme	A substance that speed up reactions between specific substances in chemical changes take place in the body.
Eosinophil	Fast acting, phagocytic (eating) white blood cell that takes part in inflammation. Increase during an allergic or parasitic condition. Like basophils, levels may be reduced by increase in corticosteroids (either produced naturally or with steroid medication).
Erythrocytes	Red blood cells (RBCs). Carry oxygen to body cells and carbon dioxide away from body cells to the lungs for disposal.
Erythropoietin	Growth factor made by the kidneys that simulates the bone marrow to produce red blood cells. Too little erythropoietin may be made if the kidneys fail resulting in anemia; synthetic erythropoietin injections or blood transfusion may be used to treat the anemia.
F
Fluorescence in situ hybridization (FISH)	A laboratory technique used to determine how many copies of a specific segment of DNA are present or missing in a cell.
Free light chains	Short protein chains on the antibody. There are two types of light chains: lambda (λ) chain, kappa (κ) chain. Antibodies are produced by B lymphocytes which each express only one class of light chain. Once set, light chain class remains fixed for the life of the B lymphocyte.
G
Gene	A hereditary unit of a sequence of DNA that occupies a fixed, specific location on a chromosome and determines a particular characteristic in an organism. Genes undergo mutation ( change) when their DNA sequence changes.
Gene therapy	Treatment that alters genes; using genes to stimulate the immune system. In studies of gene therapy for cancer, researchers are trying to improve the body’s natural ability to fight the disease and to make the tumour more sensitive to other kinds of therapy. Treatment is directed towards replacing damaged or missing genes with healthy copies.
Genetic	Inherited; information that is passed from parents to children through DNA in the genes.
H
Hematologist	A doctor who specialized in the problems of the bone marrow and blood.
Hematopoietic	The production of all types of blood cells.
Herpes Zoster (‘Shingles’)	The chicken-pox virus may remain quiet in the nerves of people who had childhood chicken pox and then it can flare up again. Reactivation of the virus results in blisters, redness, and pain along a nerve path. The risk of developing “Shingles” increases with age (>50 years), stress, poor health and chemotherapy. Antiviral medication must be started within 48 hours to be helpful. Debilitating pain that lasts long after the rash has gone (post herpatic neuralgic pain) sometimes occurs. Treatment includes antiviral oral medication, corticosteroids, antiviral creams, and pain medications. Antiviral medication (eg. Valtrex) may be given when receiving bortezomib (Velcade) to prevent “shingles” from occurring during treatment.
Hypercalcemia	Marked elevated levels of calcium in the blood likely due to increased bone destruction and possibly poor kidney function associated with myeloma. Too much calcium can cause heart irregularities and lead to coma. Treatment includes Bisphosphonates intravenously, extra fluids and control of myeloma.
I
IgG	The most common class of antibody. Helps the neutrophils and macrophages become “eaters”(phagocytosis); it is the predominant type contained in commercial gamma-globulin products. IgG protects against bacteria, viruses, and toxins and is the most common type of myeloma.
IgA	Class of antibody found at mucosal surfaces, in serum, and in secretions (saliva; tears; respiratory, GU, and GI tract secretions) where it provides an early antibacterial and antiviral defense. Second most common type of myeloma.
IgD	Class of antibody coexpressed with IgM on the surface of naive B cells.
IgE	Class of antibody present in low levels in serum and in respiratory and GI mucous secretions. Helps with releasing chemical messengers that produce an inflammatory response. IgE levels are elevated in specific immune responses (eg, allergic or extrinsic asthma, hay fever, atopic dermatitis) and parasitic infections.
IgM	The first and biggest antibody formed after exposure to new antigen. IgM circulates primarily in the blood vessels; it helps phagocytes. Usually associated with Waldenstrom’s macroglobulemia. In rare cases can be a type of myeloma.
Immunofixation electrophoresis	Also called Serum Protein Electrophoresis; SPE; A type of electrophoresis that uses a special antibody staining technique to identify individual classes of antibodies and the light or heavy chain in the blood or urine. Protein and immunofixation electrophoresis tests give your doctor a rough estimate of how much of each protein is present by the patterns they create on the electrophoresis graph identifying the presence of a particular type of immunoglobulin.
Immune system	The molecules, cells, tissues, and organs that collectively work to provide protection against infectious pathogens such as bacteria, viruses, or toxins and cancers.
Immune response	A collective and coordinated response to foreign substances in an individual mediated by the cells and molecules of the immune system.
Immune response (Innate)	(Natural or ‘native’ immunity). “Born with” mechanisms that exist before infection that can respond rapidly to microbes and that can react in the same way to repeat infections. Include such things as the skin (barrier); “eating” white blood cells (neutrophils, macrophages) and other parts of the immune system.
Immune response (Adaptive)	An exact specific immunity directed by lymphocytes to create specific antibodies and “memory” antibodies by exposure to infectious agents.
Interleukin	Another name for a naturally produced chemical made by the body that acts on white blood cells (leukocytes); or a substance used in biological therapy. Interleukins stimulate the growth and activities of certain kinds of white blood cells. Examples: Interleukin-2 (IL-2) stimulates the growth of certain blood cells in the immune system that can fight some types of cancer. Interleukin-6 (IL-6) is a potent stimulus to osteoclasts and myeloma cell activities.
J
K
L
Lesion	Area of abnormal tissue change due to disease or injury. In myeloma, “lesion” can refer to a plasmacytoma (tumor) or a hole in the bone.
Leukocytes	General term for white blood cells (WBC). Cells that help the body fight infections and other diseases.
Lymphocyte	Small white blood cell - corner stone of the adaptive immune system; may be one of two types – a T lymphocyte or a B lymphocyte.
M
Macrophages	(Greek: big eaters, from makros "large" + phagein "eat"; abbr. MΦ) are white blood cells within tissues, produced from the monocytes; in the blood they are called monocytes. Their role is to engulf and then “eat” cellular debris and pathogens either as stationary or as mobile cells, and to stimulate lymphocytes and other immune cells to respond to the pathogen.
Monocyte	A white blood cell considered to be the second line of defense against bacterial infections and foreign substances. They are stronger than neutrophils and can eat larger particles of debris. Monocytes respond later to the inflammation signals and can move quickly (approx. 8-12 hours) to sites of infection in the tissues where they turn into macrophages and dendritic cells to stimulate an immune response. Half of them are stored in the spleen.
Malignant	A severe and progressively worsening process that may be used to describe tumors characterized by the properties of rapid growth of abnormal cells, invasiveness, and spread into other tissues.
Mast cell	Lives in several types of tissues and contains many “bubble packages” rich in histamine and heparin. Although best known for their role in allergy and acute multi-system severe allergic reaction (Anaphylaxis ), mast cells play an important protective role as well, being intimately involved in wound healing and defense against pathogens.
Monoclonal	A clone or duplicate of a single cell. Myeloma develops from a single cancerous plasma cell.
Monoclonal (M) protein	Abnormal single antibody protein found in large quantities in the blood and urine of people with myeloma.
Monoclonal antibody	Single type of antibody such as the damaged myeloma cell. Or, may refer to a genetically engineered antibody specifically designed to find and bind to cancer cells for diagnostic or treatment purposes. They can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to tumor cells.
N
Neuropathy	Disorder of the nerves that result in abnormal or decreased sensation, or burning/ tingling. When hands and feet are involved it is known as peripheral neuropathy. Myeloma disease and some types of chemotherapy may produce neuropathy.
Neutrophils	During an acute infection, neutrophils are the body’s first line of defence. They are the most numerous circulating WBCs and are one of the first responders to inflammation or tissue injury sites; once they receive the appropriate signals neutrophils are recruited to the site of injury within minutes. They are the predominant cells in pus, accounting for its whitish/yellowish appearance.
O
Oncogene	A gene that has the potential to cause a normal cell to become cancerous.
Oncologist	A physician who specializes in the diagnosis and treatment of cancer. Some oncologists specialize in a specific cancer such as myeloma.
Osteoblast	Cells that build bone. Normal bone building cell.
Osteoclast	Normal cell found where the bone marrow and the bone meet; dissolves bone causing the calcium and phosphorus to be reabsorbed into the blood stream. In myeloma, the osteoclasts are over-stimulated while osteoblast (builders) activity is blocked resulting in a greater lytic (dissolving) process. Myeloma cells are found close to sites of osteoclast activity, and the interaction between myeloma cells and osteoclasts encourage both myeloma cell growth and bone disease: This bone destructive process releases factors that help the growth and survival of myeloma cells.
Osteolytic or “Lytic” lesions	Soft spot in the bone where bone tissue has been dissolved due to osteoclasts activity. The lesion appears as a hole on a standard bone x-ray.
Osteoporosis	Generalized bone loss often associated with old age, but can also occur in myeloma.
P
Palliative treatment	Treatment goal is to improve the quality of life by relieving pain and symptoms of disease but not intended to alter its course.
Phagocytes	Are the white blood cells that protect the body by “eating” (phagocytosing) harmful foreign particles, bacteria, and dead or dying cells. Professional phagocytes include the white blood cells: neutrophils, monocytes/macrophages, dentritic cells and mast cells. Phagocytes are crucial in fighting infections, as well as in maintaining healthy tissues by removing dead and dying cells that have reached the end of their lifespan.
Phagocytosis	Engulfment of solid particles (like bacteria) by specialized white blood cells which wrap their cell membrane around the foreign substance, forming a bubble around it once it is inside the cell, and then dissolving and “eating” it. The bubble is formed around the particle to be dissolved so the chemicals secreted by the cell do not damage the good working cell. Phagocytosis is involved in the acquisition of nutrients for some cells, and in the immune system it is a major mechanism used to remove pathogens and cell debris. Bacteria, dead tissue cells, and small mineral particles are all examples of objects that may be phagocytosed.
Plasma	The pale yellow coloured liquid part of the blood in which red blood cells, white blood cells, and platelets are floating.
Plasma cell	Antibody – secreting immune cell that develops from a B cell lymphocyte.
Plasmacytoma	Single tumor made up of cancerous plasma cells that occur in bone or soft tissue. Myeloma may develop in patient with a plasmacytoma.
Platelets	One of the types of blood cells made in the bone marrow. Their sticky surface lets them, along with other substances, form blood clots to stop bleeding.
Prognosis	The predicted course of a disease and the outcome after treatment.
Proteasome	A protein degradation "machine" within the cell that can digest a variety of proteins. This break down of proteins is necessary for orderly cell function and growth. A proteasome-inhibitor drug such as bortezomib (Velcade) is like blocking the “garbage disposer” – everything clogs up and the cells die off.
Q
R
Red Blood Cell	Red Blood Cells are the most numerous types in the blood. They make hemoglobin which carries oxygen from the lungs to cells and carbon dioxide from the cells to the lungs for removal. Too few red blood cells or hemoglobin results in a condition known as anemia.
Refractory disease	Disease that does not respond to treatment.
Relapse	Return of the disease or disease progression.
S
Side effects	Problems that occur due to drugs used for disease treatment. Common side effects of cancer chemotherapy are fatigue, nausea, vomiting, decreased blood cell counts, hair loss and mouth sore.
Stem cell	Parent cell that grows and divides to make new cells. eg. Blood forming stem cells in the bone marrow produce all the blood cells.
Stem cell transplant	Medical procedure in which bone marrow or peripheral blood stem cells are collected, stored, and infused into an individual following high-dose chemotherapy to restore blood cell production.
T
U
V
W
White Blood Cell (leukocyte)	One of the major cell types in the blood. An important part of the immune system geared to attack cancer cells, organisms that produce infection or disease in the body. The five kinds of white blood cells are: lymphocytes; monocytes; neutrophils; eosinophils; and basophils.
X
Y
Z