Role of the bone marrow microenvironment in tumor transformation of plasma cell dyscrasias

Abstract

Despite significant progress in the understanding of the pathogenesis of paraproteinemic hemoblastoses, these diseases remain incurable. In their development, they go through the stage of paraproteinemias, benign diseases, characterized by the detection of monoclonal paraprotein in the blood serum and / or urine, presence of clonal plasma cells in the bone marrow or in extramedullary tissues. It remains unclear why some paraproteinemias progress to multiple myeloma or other lymphoid tumors and how malignant progression occurs. An important role in the progression is played by molecular and genetic mechanisms, cytokines. Nevertheless, little is known about how the bone marrow microenvironment influences disease progression. In this review, we made an attempt to summarize the most significant biological, clinical characteristics on the course of paraproteinemias and the role of changes in the bone marrow microenvironment that contribute to malignant transformation.