Abstract
The fate of any malignant cell is determined not only by its inherent genetic abnormalities but also by the environmental conditions in which the cell resides. Multiple myeloma is characterized by the accumulation of terminally differentiated plasma cells within the bone marrow. Even though malignant cells are readily detectable within the peripheral blood of these patients, the bulk of disease typically remains within the marrow cavity until the terminal stages of a patient’s disease. Clearly, the microenvironment within the bone marrow is important for the growth of the myeloma cell. Within that bone marrow microenvironment is a complex network of cells which produce cytokines capable of supporting both malignant and normal hematopoietic cell growth. These supporting cells, primarily comprised of macrophages and fibroblasts, are collectively termed bone marrow stromal cells.
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