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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.
Together with these data, TBI may in some cases impair the early and late capacities of the marrow microenvironment to support transplanted stem cells.
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.
In our model we do not consider the possible existence of various subpopulations of MM cells that are dependent on the marrow microenvironment to variable extents and for which this model may or may not apply.
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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.
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].
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].
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.
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