Bone marrow microenvironment in myelomagenesis: its potential role in early diagnosis.
Multiple myeloma (MM) is the second most common hematological malignancy, with an overall survival of 4-6 years. It is always preceded by a premalignant stage called monoclonal gammopathy of unknown significance (MGUS). Importantly, at this time we lack reliable predictors to determine who will progress from MGUS to MM, and who will remain stable. The bone marrow microenvironment plays a key role in myelomagenesis (growth, survival and migration of malignant plasma cells). In the present review, we summarize and discuss our current understanding of the bone marrow microenvironment and its compartments in relation to myelomagenesis. Although it remains to be proven, we believe that an improved characterization of the cellular constituents, the extracellular matrix components and the soluble factors of the bone marrow could open up novel avenues to better understand underlying mechanisms of the transformation from MGUS to MM. Ultimately, this will lead to the development of early treatment of high-risk precursor disease aimed to delay/prevent MM.
Balakumaran
Arun
A
National Institute of Dental and Craniofacial Research, National Institutes of Health, Room 222, Building 30, 9000 Rockville Pike, Bethesda, MD 20892, USA.
Robey
Pamela Gehron
PG
Fedarko
Neal
N
Landgren
Ola
O
D015415:Biomarkers / Q000378:metabolism; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D001854:Bone Marrow Cells / Q000378:metabolism; D018450:Disease Progression; D042241:Early Diagnosis; D004777:Environment; D006801:Humans; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000503:physiopathology; D009101:Multiple Myeloma / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D012307:Risk Factors
D015415:Biomarkers
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