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Resident stem and immature hematopoietic progenitor cells mature under the influence of the bone marrow microenvironment to functional, mature cells of diverse lineages[14], [15].
It is upregulated by the bone marrow microenvironment to mediate proliferation and promote MM survival.
In CKD patients, vitamin D deficiency may stimulate immune cells within the bone marrow microenvironment to produce cytokines, inducing impaired erythropoiesis.
Thus, among individual patients within the del 5q) MDS subset, lenalidomide may affect the del 5q) clone and the bone marrow microenvironment to different degrees to result in hematopoietic normalization.
If malnutrition were more prevalent among the PN recipients, this may lend itself to a less hospitable bone marrow microenvironment to support engraftment, thus prolonging cytopenias, delaying engraftment and increasing the need for transfusional support.
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Genetic studies demontrated that G-CSF mediates the MPD as well as changes in the bone marrow microenvironment leading to osteopenia.
The pathways modulated by MSCs in the presence of MM cells may therefore represent important mechanisms through which the bone marrow microenvironment contributes to MM disease development.
A major devastating complication of this disease is myeloma bone disease, which is associated with increased mortality and is driven by interaction between myeloma cells and cells of the bone marrow microenvironment, leading to imbalanced bone remodeling [ 21].
Bone marrow microenvironment contributes to regulate self-renewal, commitment, differentiation, proliferation and the dynamics of apoptosis of hematopoietic progenitors [ 47], and CD34+ progenitor cells are known to be severely impacted in MDS by the composition of micro environmental stimuli [ 48].
Compounds designed to block the identified cellular interactions within the bone marrow microenvironment are expected to mobilise the leukemic cells and make them more accessible to contemporary antileukemic agents.
The bone marrow microenvironment is vital to the development, differentiation, and regulation of the lymphohematopoietic system.
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