The role of angiogenesis in multiple myeloma treatment

Abstract

Angiogenesis is an important biological process of the formation of new blood vessels from pre-existing ones. It occurs throughout life in health and disease, beginning in the prenatal stage and continuing through old age. Angiogenesis is regulated, by both activator and inhibitor molecules. Physiological angiogenesis is under the control of angioinhibitory molecules. Unregulated angiogenesis may lead to several angiogenic diseases and is thought to be indispensable for solid tumor growth and metastasis. Multiple myeloma is an incurable disease characterized by clonal plasma cell proliferation and overproduction of monoclonal paraprotein, hypercalcemia, renal failure, anemia, osteolytic bone lesions, and infections. Angiogenesis plays an important role in the biology of multiple myeloma and has a prognostic value in this disease. The pathophysiology of multiple myeloma-induced angiogenesis involves both direct production of angiogenic cytokines by plasma cells and their induction within the bone marrow microenvironment cells. Multiple myeloma has been the most intractable hematological disease for many years. Recently, basic and clinical research has advanced remarkably and a new therapeutic strategy has been established. Despite unusual progress in the therapy of multiple myeloma none of the available drugs are curative. Present clinical research focuses on the balance between treatment efficacy and quality of life. In this review, we summarize recent data about myeloma-induces angiogenesis, the mechanism involved in this process, and the treatment of multiple myeloma.