The bone marrow microenvironment - Home of the leukemic blasts

Area of Science:

• Hematology
• Oncology
• Cell Biology

Background:

• Acute Myeloid Leukaemia (AML) is a heterogeneous cancer characterized by abnormal myeloid progenitor cells in the bone marrow (BM).
• The BM microenvironment is crucial for AML survival, proliferation, and relapse, despite ex-vivo AML exhibiting high apoptosis.
• While genetic factors in AML are well-studied, the role of the BM microenvironment in disease pathogenesis remains less understood.

Purpose of the Study:

• To review the critical role of the bone marrow microenvironment in sustaining Acute Myeloid Leukaemia (AML).
• To explore the therapeutic potential of targeting the BM microenvironment to treat AML.

Main Methods:

• Literature review of existing research on BM microanatomy and its role in AML.
• Analysis of evidence supporting the BM microenvironment's function in AML blast survival and proliferation.
• Examination of therapeutic strategies focused on disrupting the AML-BM niche interaction.

Main Results:

• The BM microenvironment provides a protective niche essential for AML blast survival and proliferation.
• Minimal residual disease in the BM microenvironment contributes to relapse in AML patients.
• Leukaemic cells' genetic instability can lead to resistance against conventional chemotherapies.

Conclusions:

• The bone marrow microenvironment is a key factor in AML pathogenesis and relapse.
• Targeting the non-malignant cells within the BM microenvironment presents a novel therapeutic avenue.
• Decoupling AML from its BM niche is a potential strategy for more effective treatment.