Article ; Online: Molecular and immunological mechanisms of clonal evolution in multiple myeloma.
2023 Volume 14, Page(s) 1243997
Abstract: Multiple myeloma (MM) is a hematologic malignancy characterized by the proliferation of clonal plasma cells in the bone marrow (BM). It is known that early genetic mutations in post-germinal center B/plasma cells are the cause of myelomagenesis. The ... ...
Abstract | Multiple myeloma (MM) is a hematologic malignancy characterized by the proliferation of clonal plasma cells in the bone marrow (BM). It is known that early genetic mutations in post-germinal center B/plasma cells are the cause of myelomagenesis. The acquisition of additional chromosomal abnormalities and distinct mutations further promote the outgrowth of malignant plasma cell populations that are resistant to conventional treatments, finally resulting in relapsed and therapy-refractory terminal stages of MM. In addition, myeloma cells are supported by autocrine signaling pathways and the tumor microenvironment (TME), which consists of diverse cell types such as stromal cells, immune cells, and components of the extracellular matrix. The TME provides essential signals and stimuli that induce proliferation and/or prevent apoptosis. In particular, the molecular pathways by which MM cells interact with the TME are crucial for the development of MM. To generate successful therapies and prevent MM recurrence, a thorough understanding of the molecular mechanisms that drive MM progression and therapy resistance is essential. In this review, we summarize key mechanisms that promote myelomagenesis and drive the clonal expansion in the course of MM progression such as autocrine signaling cascades, as well as direct and indirect interactions between the TME and malignant plasma cells. In addition, we highlight drug-resistance mechanisms and emerging therapies that are currently tested in clinical trials to overcome therapy-refractory MM stages. |
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MeSH term(s) | Humans ; Multiple Myeloma/therapy ; Multiple Myeloma/drug therapy ; Plasma Cells/metabolism ; Bone Marrow/metabolism ; Hematologic Neoplasms ; Clonal Evolution/genetics ; Tumor Microenvironment/genetics |
Language | English |
Publishing date | 2023-09-06 |
Publishing country | Switzerland |
Document type | Journal Article ; Review |
ZDB-ID | 2606827-8 |
ISSN | 1664-3224 ; 1664-3224 |
ISSN (online) | 1664-3224 |
ISSN | 1664-3224 |
DOI | 10.3389/fimmu.2023.1243997 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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