The microenvironment in mature B-cell malignancies: a target for new treatment strategies.

Abstract:

:Despite major therapeutic advances, most mature B-cell malignancies remain incurable. Compelling evidence suggests that crosstalk with accessory stromal cells in specialized tissue microenvironments, such as the bone marrow and secondary lymphoid organs, favors disease progression by promoting malignant B-cell growth and drug resistance. Therefore, disrupting the crosstalk between malignant B cells and their milieu is an attractive novel strategy for treating selected mature B-cell malignancies. Here we summarize the current knowledge about the cellular and molecular interactions between neoplastic B lymphocytes and accessory cells that shape a supportive microenvironment, and the potential therapeutic targets that are emerging, together with the new problems they raise. We discuss clinically relevant aspects and provide an outlook into future biologically oriented therapeutic strategies. We anticipate a paradigm shift in the treatment of selected B-cell malignancies, moving from targeting primarily the malignant cells toward combining cytotoxic drugs with agents that interfere with the microenvironment's proactive role. Such approaches hopefully will help eliminating residual disease, thereby improving our current therapeutic efforts.

journal_name

Blood

journal_title

Blood

authors

Burger JA,Ghia P,Rosenwald A,Caligaris-Cappio F

doi

10.1182/blood-2009-06-225326

subject

Has Abstract

pub_date

2009-10-15 00:00:00

pages

3367-75

issue

16

eissn

0006-4971

issn

1528-0020

pii

blood-2009-06-225326

journal_volume

114

pub_type

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