Game of Bones: How Myeloma Manipulates Its Microenvironment

• Authors: Tyler Moser-Katz, Emory University; Nisha Joseph, Emory University; Madhav Dhodapkar, Emory University; Kelvin P Lee, Roswell Park Cancer Institute, Buffalo; Lawrence Boise, Emory University
• Journal Title: FRONTIERS IN ONCOLOGY
• Volume: Volume 10
• Publisher: FRONTIERS MEDIA SA | 2021-02-09, Pages 625199-625199
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.3389/fonc.2020.625199
• Subjects: Health Sciences, Oncology; Health Sciences, Immunology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Oncology; multiple myeloma; bone marrow microenviroment; MGUS; smoldering myeloma; myeloma therapy

Abstract

Multiple myeloma is a clonal disease of long-lived plasma cells and is the second most common hematological cancer behind Non-Hodgkin’s Lymphoma. Malignant transformation of plasma cells imparts the ability to proliferate, causing harmful lesions in patients. In advanced stages myeloma cells become independent of their bone marrow microenvironment and form extramedullary disease. Plasma cells depend on a rich array of signals from neighboring cells within the bone marrow for survival which myeloma cells exploit for growth and proliferation. Recent evidence suggests, however, that both the myeloma cells and the microenvironment have undergone alterations as early as during precursor stages of the disease. There are no current therapies routinely used for treating myeloma in early stages, and while recent therapeutic efforts have improved patients’ median survival, most will eventually relapse. This is due to mutations in myeloma cells that not only allow them to utilize its bone marrow niche but also facilitate autocrine pro-survival signaling loops for further progression. This review will discuss the stages of myeloma cell progression and how myeloma cells progress within and outside of the bone marrow microenvironment.