A closer look at the bone marrow microenvironment in multiple myeloma

Abstract

Multiple myeloma, a plasma cell (PC) neoplasm accounting for nearly 10% of hematologic malignancies, remains an incurable disease of the bone marrow (BM) with a fascinating pathophysiology. The maladaptive nature of myeloma PCs and the BM microenvironment niche has been recognized to play a crucial role in the pathogenesis and progression of the disease which behaves in a manner similar to solid tumors in their growth and dissemination. A complex interaction between osteoclasts, endothelial cells, BM matrix, myeloid as well as the lymphoid elements and the malignant PCs occurs at the level of the microenvironment favoring the expansion of latter cells and their spread. A better understanding of the diseased PC and their milieu will enable the development of novel therapeutic tools capable of improving the outcome of this incurable blood cancer.