Newly Diagnosed Patients:
How Plasma Cells Transform Into Myeloma Cells
Normal plasma cells (B cells) transform into malignant plasma cells (myeloma cells) through a multistep process.
The process begins when specific adhesion molecules on the surface of myeloma cells allow the cells to bind to stromal cells in the bone marrow. This attachment allows both the stromal cells and the myeloma cells to produce chemical messengers called cytokines that cause the further development of myeloma.
- Stromal cells produce an increased amount of the cytokine interleukin-6 (IL-6), which is necessary for the continued growth and survival of the myeloma cells. The high level of IL-6 leads to an uncontrolled increase in the number of myeloma cells.
- Myeloma cells produce an increased amount of IL-1-beta and tumor necrosis factor-beta (TNF-beta), two cytokines that activate the development of osteoclasts, cells that break down bone as part of normal bone remodeling. However, in multiple myeloma, the increased number of osteoclasts causes damage to bone.
- Myeloma cells also produce growth factors, such as vascular endothelial growth factor (VEGF), that promote angiogenesis, or the creation of new blood vessels. These new blood vessels bring oxygen and nutrients to the tumor, helping it to grow by generating new myeloma cells.
- Mature myeloma cells may fail to activate the immune system, which means that the body’s immune system will not respond to a foreign substance. This failure results in a growing number of myeloma cells.