Da Silva-De Abreu AJ, Menoni-Blanco BJ

Language: Spanish
References: 46
Page: 23-30
PDF size: 222.13 Kb.

ABSTRACT

In Multiple myeloma (MM) is a malign tumor that develops predominantly intramedullar; except in most advanced stages when it can have extramedullar compromise, in such a way that most part of its evolution it remains in intimate relationship with bone marrow microenvironment, where tumor plasmocites (PT) and stromal cells (CE) interact in a complex net of molecular mechanisms. Through certain mechanisms; so far not completely clarified, it has been demonstrated that molecular pathways implied in interactions between PT and CE may vary according to early alterations in tumor development, being the microenvironment able to take part in overexpression of some signaling cascades. Besides the wide range of interleukins of autocrine and paracrine actions (p. ex. IL-6, IGF-1, VEGF, TNF), homotypic and heterotypic adhesion molecules between PT-CE (p. ex. VLA-4) and PT-extracellular matrix proteins (PME) (p. ex. syndecan-1, MPC-1) play a role in treatment resistance, proliferation, angiogenesis, apoptosis suppression and bone reabsorption. In MM, PT establishes an intimate relationship with bone marrow microenvironment, where it manages to set the ideal circumstances for tumor progression. With the development of new technologies and knowledge on molecular physiopathology of MM, it has been possible to develop better therapeutic strategies that approximate to the challenge of this disease; so far considered incurable, in a more efficient and effective way.

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