Bone marrow microenvironment in Waldenstrom's Macroglobulinemia

Waldenstrom Macroglobulinemia (WM) is a low-grade B-cell lymphoma defined firstly by infiltration of lymphoplasmacytic cells into the bone marrow (BM), the milieu where the cells acquire signals that promote malignant growth and proliferation. A second characteristic associated with WM is the increased synthesis of monoclonal immunoglobulin M (IgM) by lymphoplasmacytic cells, which is secreted in the serum and often results in hyperviscosity. Advanced genomic tools have improved our understanding of the genetic events that contribute to malignant transformation in WM, but the role of BM microenvironment is also emerging as having an essential role in WM disease progression. Therefore, delineation of malignant WM cell growth in the context of its microenvironment would benefit the design of more efficient therapeutic strategies. Here, we highlight available data regarding the interaction of the WM cells with the cellular and non-cellular compartments of the BM and discuss how BM provides a permissive environment for WM cell growth and proliferation.