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Stromal abnormalities in neoplastic bone marrow diseases

U Dührsen1, D K Hossfeld

  • 1Abteilung für Onkologie und Hämatologie, Universitätskrankenhaus Eppendorf, Hamburg, Germany.

Annals of Hematology
|August 1, 1996
PubMed
Summary

Bone marrow malignancies involve abnormal blood-forming cells interacting with their supportive stromal environment. Stromal abnormalities can promote cancer growth through three main mechanisms, potentially leading to new therapies.

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Area of Science:

  • Hematology
  • Oncology
  • Cell Biology

Background:

  • Bone marrow malignancies originate from neoplastic transformation of hematopoietic stem or progenitor cells.
  • These malignant cells rely on the bone marrow stromal microenvironment for survival and proliferation.
  • Emerging evidence suggests the microenvironment actively participates in disease progression.

Purpose of the Study:

  • To review literature on stromal abnormalities in leukemias, myelodysplastic syndromes, and multiple myeloma.
  • To identify mechanisms by which stromal derangements contribute to neoplastic disease evolution.
  • To explore potential for novel therapeutic strategies targeting the stroma.

Main Methods:

  • Literature review of stromal abnormalities in hematologic malignancies.

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  • Analysis of mechanisms linking stromal derangements to neoplastic disease.
  • Categorization of stroma-related disease mechanisms.

    • Main Results:

    • Three principal mechanisms of stromal contribution to neoplastic disease identified.
    • 'Malignancy-induced microenvironment': Malignant cells alter stroma for improved growth.
    • 'Malignant microenvironment': Abnormal malignant cells within stroma stimulate cancer, inhibit normal cells.
    • 'Malignancy-inducing microenvironment': Primary stromal defect leads to neoplastic cell emergence.

    Conclusions:

    • Stromal abnormalities play a critical role in the pathogenesis of bone marrow malignancies.
    • Understanding these stroma-related mechanisms offers insights into disease evolution.
    • This knowledge may pave the way for developing alternative therapeutic approaches targeting the microenvironment.