Breaking barriers: The role of the bone marrow microenvironment in multiple myeloma progression

The bone marrow barrier (BMB) plays a critical role in multiple myeloma (MM). BMB, composed of bone marrow endothelial cells and stromal cells, fosters the survival and growth of MM cells by secreting various supportive factors. Despite advancements in treatments, MM often relapses, primarily due to the protective microenvironment provided by the bone marrow. Key molecular interactions within the BMB that facilitate MM cell retention and resistance to therapies are identified. Targeting these interactions, especially in combination with existing immunotherapies, could lead to more effective and durable treatment outcomes.