title: A novel role for the marrow microenvironment in initiating and sustaining hematopoietic disease.
abstract: BACKGROUND
  The marrow microenvironment is composed of a complex network of cells and extra cellular matrix that cooperate to regulate normal hematopoiesis. There is growing evidence that microenvironmental defects can contribute to the pathogenesis of hematological malignancies.
  
  
  OBJECTIVE
  We review the role of the microenvironment in inducing and sustaining hematological malignancies.
  
  
  CONCLUSIONS
  Two basic mechanisms could explain the role of microenvironmental defects in the evolution of hematopoietic neoplasms. There is significant data to support the first mechanism, in which the malignant hematopoietic clone induces reversible functional changes in the microenvironment that result in improved growth conditions for the malignant cells. More recent studies from mouse models have indicated that a second mechanism involving primary microenvironmental defects can also result in malignancy.
authors.affiliation: University of Washington School of Medicine, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.
authors.forename: Aravind
authors.initials: A
authors.lastname: Ramakrishnan
authors.forename: H Joachim
authors.initials: HJ
authors.lastname: Deeg
mesh_terms: D001854:Bone Marrow Cells / Q000502:physiology*; D002450:Cell Communication; D006402:Hematologic Diseases / Q000209:etiology; D019337:Hematologic Neoplasms / Q000209:etiology*; D006410:Hematopoiesis; D006412:Hematopoietic Stem Cells / Q000502:physiology; D006801:Humans; D017154:Stromal Cells / Q000502:physiology