title: Anemia in multiple myeloma: role of deregulated plasma cell apoptosis.
abstract: Anemia of variable severity occurs in more than two-thirds of patients with multiple myeloma (MM). Besides the altered cytokine network, chronic erythropoietin deficiency, blood loss and hemolysis, we have shown that deregulated myeloma cell apoptosis may contribute to progressive destruction of the erythroid matrix by inducing erythroblast cytotoxicity. To exert this effect, highly malignant plasma cells overexpress both Fas-ligand (Fas-L) and TRAIL, which efficiently trigger the death of immature erythroblasts. In view of severe progression of MM in patients with Fas-L/TRAIL-based anemia, overexpression of these apoptogen receptors may characterize a peculiar cytotoxic-apoptogenic phenotype in malignant plasma cells. Early immunophenotyping of myeloma cells could thus help to identify patients with a higher risk of erythropoiesis exhaustion.
authors.affiliation: DIMO, Department of Biomedical Sciences and Human Oncology, University of Bari, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Tucci
authors.forename: Daniela
authors.initials: D
authors.lastname: Grinello
authors.forename: Paola
authors.initials: P
authors.lastname: Cafforio
authors.forename: Franco
authors.initials: F
authors.lastname: Silvestris
authors.forename: Franco
authors.initials: F
authors.lastname: Dammacco
mesh_terms: D000740:Anemia / Q000209:etiology*; D017209:Apoptosis / Q000502:physiology*; D015550:Cell Degranulation / Q000502:physiology*; D004900:Erythroblasts / Q000502:physiology; D006801:Humans; D008407:Mast Cells / Q000502:physiology*; D009101:Multiple Myeloma / Q000097:blood*