Abstract

Multiple Myeloma (MM), a bone marrow plasma cell hematopoietic cancer, remains a critical but incurable hematological malignancy, prone to deadly relapses even after existing treatment. In this review, I describe the origins of pro-tumor myeloma-associated macrophages. I specifically outline how classically activated anti-tumor macrophages that home to the cancerous bone marrow tumor microenvironment is polarized into pro-tumor macrophages. We then explain how these myeloma-associated macrophages play an important role in supporting multiple myeloma by enabling drug resistance, improved growth, angiogenesis, and protection. We also describe several treatments in development aimed to sever the supportive link between myeloma-associated macrophages and MM by blocking signaling pathways, destroying, or repolarizing macrophages and even preventing macrophage polarization in the first place. We conclude that careful study is needed to improve the reliability of targeting myeloma-associated macrophages to reduce MM relapse and comprehensively treat this cancer.

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