Review Article

The Pathogenesis of Multiple Myeloma: Understanding the Mechanisms of the Bone Marrow Microenvironment

Angela M. Falco, RN, MS/MPH, ANP-C, Lisa C. Smith, MSN, FNP, AOCN®, and 
Ellen Sullivan, OCN®, MNSC, APN, ACNP-BC

From Celgene Corporation (all authors are clinical nurse consultants)
.

Angela M. Falco, Lisa C. Smith, and Ellen Sullivan are employees of Celgene Corporation.

Correspondence to: Angela M. Falco, RN, MS/MPH, ANP-C, 2715 West 37th Avenue, Denver, CO 80211. E-mail: afalco@celgene.com


J Adv Pract Oncol 2011;2:11–24 | DOI: 10.6004/jadpro.2011.2.1.2 | © 2011 Harborside Press®


  

ABSTRACT

Multiple myeloma, a mature B-cell malignancy, is the second most common hematologic malignancy in the United States. Research has highlighted the importance of the bone marrow microenvironment in contributing to the pathogenesis of multiple myeloma via a network of complex interactions. As a result, novel agents have been developed that target the cellular and molecular mechanisms of the disease. In order to prescribe novel agents appropriately, monitor for response, and manage adverse effects, advanced practitioners will need to keep abreast of all the new molecules, signaling pathways, and relevant interactions that occur in the bone marrow microenvironment contributing to myeloma. This article will provide a review of the differentiation pathway of B lymphocytes into plasma cells, the cellular and molecular anatomy of the bone marrow microenvironment, as well as the most current findings of how the myeloma cell impacts the bone marrow microenvironment.


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