BETA - Does the bone marrow microenvironment (BMME) of a myeloma patient resemble the BMME of a healthy patient?

In this Health Tree University lesson, we will learn how the bone marrow immune microenvironment of a healthy individual differs from the microenvironment of a person living with myeloma. The bone marrow microenvironment per se has the same function in a healthy patient, healthy individual and in a patient with myeloma, that is to make blood cells. However, we know that some populations are different in patients with multiple myeloma. What is actually interesting to know is that sometimes these changes can occur early on, even in the MGAS stage or in the small myeloma stage, which are precursor stages of myeloma. These are primalignal conditions. And there have been several studies, some using more very sophisticated techniques, such as single-cell RNA sequencing or just looking at tissue imaging by codex, practically telling us that there is really a shift, a change in the type of immune cells and stroma cells has the disease changes and progress. So for instance, there is usually an increase in like exhausted T cells. So exhausted T cells means that these T cells are tired practically, as the word exhausted means. And these T cells are not really good in doing what they're supposed to do, that is to kill the cancer cell. So this is very typical and it's been associated with reduced response to biospecifics and like car T-cellular therapies. Other differences we see changes in not just the lymphoid or immune cells, but also in the bone cells. So we know from the beginning that patients with myeloma are more prone to have fractures that have holes in their bones. And this is mainly because the bone marrow microenvironment in patients with myeloma is different than in patients that are individuals that are healthy. And myeloma cells kind of like support more the osteoclastic, that is the bone destroying activity compared to making new bones. These are the osteoblasts. So while in new, in healthy individuals, usually there is a balance between bone destruction and bone remodeling. In myeloma patient, we have kind of like a lack of bone production. That's why we have therapies such as biphosphonate that are kind of helping switch and shift the balance toward bone remodeling and bone making.