The Role of Tumor Microenvironment in Multiple Myeloma Development and Progression
Open accessAbstract
Multiple myeloma (MM) is a hematologic cancer characterized by clonal proliferation of plasma cells in the bone marrow (BM). The progression, from the early stages of the disease as monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) to MM and occasionally extramedullary disease, is drastically affected by the tumor microenvironment (TME). Soluble factors and direct cell–cell interactions regulate MM plasma cell trafficking and homing to the BM niche. Mesenchymal stromal cells, osteoclasts, osteoblasts, myeloid and lymphoid cells present in the BM create a unique milieu that favors MM plasma cell immune evasion and promotes disease progression. Moreover, TME is implicated in malignant cell protection against anti-tumor therapy. This review describes the main cellular and non-cellular components located in the BM, which condition the immunosuppressive environment and lead the MM establishment and progression.
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Multiple myeloma cells may function remotely to create new premetastatic niches for tumor spread in other bone areas by secreting growth factors, cytokines, and exosomes that alter the extracellular matrix in these new locations.
“Moreover, as previously indicated, MM cells may now function remotely to create new premetastatic niches for tumor spread in other bone areas by secreting growth factors, cytokines, and exosomes that alter the ECM in these new locations [291].”
From Mesenchymal stromal cells in bone marrow niche of patients with multiple myeloma: a double-edged sword (2025) · cites this paper as [291]
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- Authors
- García-Ortiz, A., Rodríguez-García, Y., Encinas, J., Maroto-Martín, E., Castellano, E., Teixidó, J., & Martínez-López, J.
- Affiliations
- Research Institute Hospital 12 de Octubre (ES)
- Department of Molecular Biomedicine, Centro de Investigaciones Biológicas, CSIC, ES 28040 Madrid, Spain
- Hematology Department, Hospital 12 de Octubre, i+12, CNIO, CIBERONC, ES 28041 Madrid, Spain
- Venue
- Cancers
- Publisher
- MDPI AG
- Published
- 2021-01-09
- Volume
- 13
- Issue
- 2
- Pages
- 217
- ISSN
- 2072-6694 (ISSN-L)
- PMC
- PMC7827690
- OpenAlex
- W3121051888
- Cited by
- 238
- References
- 233
- Citations by year
- 2026: 39 · 2025: 50 · 2024: 45 · 2023: 44 · 2022: 42 · 2021: 18
- FWCI
- 6.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cancers (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Docta Complutense (Universidad Complutense de Madrid) (submittedVersion, cc-by)
- DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Instituto de Salud Carlos III (ISCIII) (PI18/01519)
- Spanish Ministry of Science, Innovation and Universities (SAF2017-85146-R)
- Topics
- Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
- Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
- Health Sciences › Medicine › Oncology › Bone health and treatments
- Keywords
- multiple myeloma, tumor microenvironment, bone marrow microenvironment, bone marrow homing, mesenchymal stem cells, osteoclasts, osteoblasts, myeloid cells, lymphoid cells, immune evasion, disease progression, monoclonal gammopathy of undetermined significance, smoldering multiple myeloma, extramedullary disease, drug resistance
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