Jornal de Pesquisa Óssea
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Multiple Myeloma: The Role of Angiogenesis in Disease Progression

Roberto Ria, Simona Berardi, Antonia Reale, Annunziata De Luisi, Ivana Catacchio, Vito Racanelli and Angelo Vacca

Angiogenesis, the formation of new blood vessels from pre-existing ones, plays an important role in the biology of multiple myeloma and has a prognostic value in this disease. Multiple myeloma is a plasma cell malignancy that home to and expand in the bone marrow where actively interacts with stromal cells inducing neovascularization, a constant hallmark of disease progression. Myeloma-induced angiogenesis involves either the direct production of angiogenic molecules by myeloma cells and the recruitment and activation of bone marrow stromal cells. Indeed, the angiogenic factors released in the bone marrow microenvironment by multiple myeloma plasma cells stimulate stromal cells to secrete their own angiogenic factors and induce the acquisition of a phenotypic and functional adaptation by non-endothelial cells, such as macrophages, which contribute to the completion of the neovessel wall (vasculogenic mimicry). In this review we summarize recent data which give strong evidence for an increased angiogenic activity in the bone marrow microenvironment and support the hypothesis that angiogenesis is not only important for tumour growth but may also promote plasma cell growth in multiple myeloma.