Inflammation as a Keystone of Bone Marrow Stroma Alterations in Primary Myelofibrosis

Primary myelofibrosis (PMF) is a clonal myeloproliferative neoplasm where severity as well as treatment complexity is mainly attributed to a long lasting disease and presence of bone marrow stroma alterations as evidenced by myelofibrosis, neoangiogenesis, and osteosclerosis. While recent understand...

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Main Authors: Christophe Desterke, Christophe Martinaud, Nadira Ruzehaji, Marie-Caroline Le Bousse-Kerdilès
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Mediators of Inflammation
Online Access:http://dx.doi.org/10.1155/2015/415024
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author Christophe Desterke
Christophe Martinaud
Nadira Ruzehaji
Marie-Caroline Le Bousse-Kerdilès
author_facet Christophe Desterke
Christophe Martinaud
Nadira Ruzehaji
Marie-Caroline Le Bousse-Kerdilès
author_sort Christophe Desterke
collection DOAJ
description Primary myelofibrosis (PMF) is a clonal myeloproliferative neoplasm where severity as well as treatment complexity is mainly attributed to a long lasting disease and presence of bone marrow stroma alterations as evidenced by myelofibrosis, neoangiogenesis, and osteosclerosis. While recent understanding of mutations role in hematopoietic cells provides an explanation for pathological myeloproliferation, functional involvement of stromal cells in the disease pathogenesis remains poorly understood. The current dogma is that stromal changes are secondary to the cytokine “storm” produced by the hematopoietic clone cells. However, despite therapies targeting the myeloproliferation-sustaining clones, PMF is still regarded as an incurable disease except for patients, who are successful recipients of allogeneic stem cell transplantation. Although the clinical benefits of these inhibitors have been correlated with a marked reduction in serum proinflammatory cytokines produced by the hematopoietic clones, further demonstrating the importance of inflammation in the pathological process, these treatments do not address the role of the altered bone marrow stroma in the pathological process. In this review, we propose hypotheses suggesting that the stroma is inflammatory-imprinted by clonal hematopoietic cells up to a point where it becomes “independent” of hematopoietic cell stimulation, resulting in an inflammatory vicious circle requiring combined stroma targeted therapies.
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issn 0962-9351
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series Mediators of Inflammation
spelling doaj-art-e13fefbf39e44dbd91dcab0ad005e9e72025-08-20T03:25:59ZengWileyMediators of Inflammation0962-93511466-18612015-01-01201510.1155/2015/415024415024Inflammation as a Keystone of Bone Marrow Stroma Alterations in Primary MyelofibrosisChristophe Desterke0Christophe Martinaud1Nadira Ruzehaji2Marie-Caroline Le Bousse-Kerdilès3Inserm UMS33, Paul Brousse Hospital, 14 Avenue Paul-Vaillant Couturier, 94800 Villejuif, FranceDepartment of Clinical Biology, HIA Percy, 101 Avenue Henri Barbusse, 92140 Clamart, FranceInserm UMR-S1197, Paul Brousse Hospital, 14 Avenue Paul-Vaillant Couturier, 94800 Villejuif, FranceInserm UMR-S1197, Paul Brousse Hospital, 14 Avenue Paul-Vaillant Couturier, 94800 Villejuif, FrancePrimary myelofibrosis (PMF) is a clonal myeloproliferative neoplasm where severity as well as treatment complexity is mainly attributed to a long lasting disease and presence of bone marrow stroma alterations as evidenced by myelofibrosis, neoangiogenesis, and osteosclerosis. While recent understanding of mutations role in hematopoietic cells provides an explanation for pathological myeloproliferation, functional involvement of stromal cells in the disease pathogenesis remains poorly understood. The current dogma is that stromal changes are secondary to the cytokine “storm” produced by the hematopoietic clone cells. However, despite therapies targeting the myeloproliferation-sustaining clones, PMF is still regarded as an incurable disease except for patients, who are successful recipients of allogeneic stem cell transplantation. Although the clinical benefits of these inhibitors have been correlated with a marked reduction in serum proinflammatory cytokines produced by the hematopoietic clones, further demonstrating the importance of inflammation in the pathological process, these treatments do not address the role of the altered bone marrow stroma in the pathological process. In this review, we propose hypotheses suggesting that the stroma is inflammatory-imprinted by clonal hematopoietic cells up to a point where it becomes “independent” of hematopoietic cell stimulation, resulting in an inflammatory vicious circle requiring combined stroma targeted therapies.http://dx.doi.org/10.1155/2015/415024
spellingShingle Christophe Desterke
Christophe Martinaud
Nadira Ruzehaji
Marie-Caroline Le Bousse-Kerdilès
Inflammation as a Keystone of Bone Marrow Stroma Alterations in Primary Myelofibrosis
Mediators of Inflammation
title Inflammation as a Keystone of Bone Marrow Stroma Alterations in Primary Myelofibrosis
title_full Inflammation as a Keystone of Bone Marrow Stroma Alterations in Primary Myelofibrosis
title_fullStr Inflammation as a Keystone of Bone Marrow Stroma Alterations in Primary Myelofibrosis
title_full_unstemmed Inflammation as a Keystone of Bone Marrow Stroma Alterations in Primary Myelofibrosis
title_short Inflammation as a Keystone of Bone Marrow Stroma Alterations in Primary Myelofibrosis
title_sort inflammation as a keystone of bone marrow stroma alterations in primary myelofibrosis
url http://dx.doi.org/10.1155/2015/415024
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AT mariecarolineleboussekerdiles inflammationasakeystoneofbonemarrowstromaalterationsinprimarymyelofibrosis