The role of the bone marrow microenvironment in the pathophysiology of myeloma and its significance in the development of more effective therapies.
Multiple myeloma (MM) is viewed as a prototypic disease state for the study of how neoplastic cells interact with their local bone marrow (BM) microenvironment. This interaction reflects not only the osteo-tropic clinical behavior of MM and the clinical impact of the lytic bone lesions caused by its tumor cells but also underlines the broadly accepted notion that nonneoplastic cells of the BM can attenuate the activity of cytotoxic chemotherapy and glucocorticoids. This article summarizes the recent progress in characterization, at the molecular and cellular levels, of how the BM milieu interacts with MM cells and modifies their biologic behavior.
Mitsiades
Constantine S
CS
Jerome Lipper Myeloma Center, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 44 Binney Street, Boston, MA 02115, USA. constantine_mitsiades@dfci.harvard.edu
McMillin
Douglas W
DW
Klippel
Steffen
S
Hideshima
Teru
T
Chauhan
Dharminder
D
Richardson
Paul G
PG
Munshi
Nikhil C
NC
Anderson
Kenneth C
KC
D001853:Bone Marrow / Q000502:physiology*; D002450:Cell Communication / Q000502:physiology*; D006801:Humans; D009101:Multiple Myeloma / Q000503:physiopathology* / Q000628:therapy; D010010:Osteoclasts / Q000502:physiology; D017154:Stromal Cells / Q000502:physiology