Deciphering the bone marrow microenvironment’s role in multiple myeloma immunotherapy resistance

Multiple Myeloma (MM) is a malignant monoclonal gammopathy characterized by the proliferation of plasma cells (PC) in the bone marrow (BM). The tight cross-talk between the BM microenvironment and PC is the hallmark of MM. The BM microenvironment comprises a cellular compartment, consisting of hemat...

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Main Authors: Nicolas Thomas Iannozzi, Nicola Giuliani, Paola Storti
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1613265/full
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author Nicolas Thomas Iannozzi
Nicola Giuliani
Nicola Giuliani
Paola Storti
author_facet Nicolas Thomas Iannozzi
Nicola Giuliani
Nicola Giuliani
Paola Storti
author_sort Nicolas Thomas Iannozzi
collection DOAJ
description Multiple Myeloma (MM) is a malignant monoclonal gammopathy characterized by the proliferation of plasma cells (PC) in the bone marrow (BM). The tight cross-talk between the BM microenvironment and PC is the hallmark of MM. The BM microenvironment comprises a cellular compartment, consisting of hematopoietic and non-hematopoietic cells. The first includes myeloid cells, T- and B-lymphocytes, natural killer (NK) cells, macrophages, and osteoclasts (OCs). In contrast, non-hematopoietic cell types include BM-derived mesenchymal stromal cells (MSCs), osteoblasts, adipocytes and endothelial cells. Besides the cellular compartment, there is a non-cellular compartment that includes extracellular matrix, growth factors, chemokines, and several cytokines. All these members play distinctive but interacting roles in the progression of MM and the drug response. MM remains an incurable disease, but in the last years immunotherapy has emerged as an important tool in the treatment of MM. The involvement of the BM microenvironment is a relevant barrier in the response to immunotherapy and in generating resistance. In this review, we provide an overview of the BM microenvironment perturbation in MM patients and how it can determine the possible resistance to immunotherapy, including monoclonal antibodies (mAbs), antibody-drug conjugates, chimeric antigen receptor T-cell (CAR-T), and bispecific T-cell engagers (BsAbs).
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spelling doaj-art-fcae9bf5c00e4e8bba35be0dcd07d28f2025-08-20T02:39:45ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-07-011610.3389/fimmu.2025.16132651613265Deciphering the bone marrow microenvironment’s role in multiple myeloma immunotherapy resistanceNicolas Thomas Iannozzi0Nicola Giuliani1Nicola Giuliani2Paola Storti3Department of Medicine and Surgery, University of Parma, Parma, ItalyDepartment of Medicine and Surgery, University of Parma, Parma, ItalyHematology, Azienda Ospedaliero-Universitaria di Parma, Parma, ItalyDepartment of Medicine and Surgery, University of Parma, Parma, ItalyMultiple Myeloma (MM) is a malignant monoclonal gammopathy characterized by the proliferation of plasma cells (PC) in the bone marrow (BM). The tight cross-talk between the BM microenvironment and PC is the hallmark of MM. The BM microenvironment comprises a cellular compartment, consisting of hematopoietic and non-hematopoietic cells. The first includes myeloid cells, T- and B-lymphocytes, natural killer (NK) cells, macrophages, and osteoclasts (OCs). In contrast, non-hematopoietic cell types include BM-derived mesenchymal stromal cells (MSCs), osteoblasts, adipocytes and endothelial cells. Besides the cellular compartment, there is a non-cellular compartment that includes extracellular matrix, growth factors, chemokines, and several cytokines. All these members play distinctive but interacting roles in the progression of MM and the drug response. MM remains an incurable disease, but in the last years immunotherapy has emerged as an important tool in the treatment of MM. The involvement of the BM microenvironment is a relevant barrier in the response to immunotherapy and in generating resistance. In this review, we provide an overview of the BM microenvironment perturbation in MM patients and how it can determine the possible resistance to immunotherapy, including monoclonal antibodies (mAbs), antibody-drug conjugates, chimeric antigen receptor T-cell (CAR-T), and bispecific T-cell engagers (BsAbs).https://www.frontiersin.org/articles/10.3389/fimmu.2025.1613265/fullmultiple myelomaresistancemesenchymal cellscar-tbi-specific antibodies
spellingShingle Nicolas Thomas Iannozzi
Nicola Giuliani
Nicola Giuliani
Paola Storti
Deciphering the bone marrow microenvironment’s role in multiple myeloma immunotherapy resistance
Frontiers in Immunology
multiple myeloma
resistance
mesenchymal cells
car-t
bi-specific antibodies
title Deciphering the bone marrow microenvironment’s role in multiple myeloma immunotherapy resistance
title_full Deciphering the bone marrow microenvironment’s role in multiple myeloma immunotherapy resistance
title_fullStr Deciphering the bone marrow microenvironment’s role in multiple myeloma immunotherapy resistance
title_full_unstemmed Deciphering the bone marrow microenvironment’s role in multiple myeloma immunotherapy resistance
title_short Deciphering the bone marrow microenvironment’s role in multiple myeloma immunotherapy resistance
title_sort deciphering the bone marrow microenvironment s role in multiple myeloma immunotherapy resistance
topic multiple myeloma
resistance
mesenchymal cells
car-t
bi-specific antibodies
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1613265/full
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AT nicolagiuliani decipheringthebonemarrowmicroenvironmentsroleinmultiplemyelomaimmunotherapyresistance
AT paolastorti decipheringthebonemarrowmicroenvironmentsroleinmultiplemyelomaimmunotherapyresistance