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Bone is the third most common location for metastasis, after the lung and liver. [13] While any type of cancer is capable of forming metastatic tumors within bone, the microenvironment of the marrow tends to favor particular types of cancer, including prostate, breast, and lung cancers. [4]
The initial change, often involving one chromosome 14 translocation, establishes a clone of bone marrow plasma cells that causes the asymptomatic disorder MGUS, which is a premalignant disorder characterized by increased numbers of plasma cells in the bone marrow or the circulation of a myeloma protein immunoglobulin. Further genetic or ...
The concept of the tumor microenvironment (TME) dates back to 1863 when Rudolf Virchow established a connection between inflammation and cancer. However, it was not until 1889 that Stephen Paget's seed and soil theory introduced the important role of TME in cancer metastasis, highlighting the intricate relationship between tumors and their surrounding microenvironment.
Tumor cells found in the bone marrow are known as disseminated tumor cells (DTCs), and those found in the peripheral blood are known as circulating tumor cells (CTCs). These cells have successfully left the primary tumor microenvironment and the SNLs, and are able to survive in a non-native environment, which makes them more aggressive. [3]
Clinically, in 128 patients with breast cancer it was found that patients with more M2 tumor-associated macrophages had higher-grade tumors, greater microvessel density, and worse overall survival. Patients with more M1 tumor-associated macrophages displayed the opposite effect. [23] [24]
Despite his diagnosis, she says, "He told me though, that it was the type of cancer that he would most likely outlive." Frank Micelotta/Disney via Getty Images (L) Gerry Turner and Theresa Nist
According to the Mayo Clinic, the disease changes white blood cells into cancer cells and builds up in the bone marrow, the spongy material inside the bones where blood cells are made.
The more aggressive forms of disease require treatment with chemotherapy, radiotherapy, immunotherapy and—in some cases—a bone marrow transplant. The use of rituximab has been established for the treatment of B-cell–derived hematologic malignancies, including follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL). [7]