The Role of Tumor Microenvironment in Multiple Myeloma Development and Progression

Multiple myeloma (MM) is a hematologic cancer characterized by clonal proliferation of plasma cells in the bone marrow (BM). The progression, from early stages disease as monoclonal gammopathy undetermined significance (MGUS) and smoldering multiple (SMM) to MM occasionally extramedullary disease, drastically affected tumor microenvironment (TME). Soluble factors direct cell–cell interactions regulate cell trafficking homing BM niche. Mesenchymal stromal cells, osteoclasts, osteoblasts, myeloid lymphoid present create unique milieu that favors immune evasion promotes progression. Moreover, TME implicated malignant protection against anti-tumor therapy. This review describes main cellular non-cellular components located BM, which condition immunosuppressive environment lead establishment