Bone marrow infiltration by multiple myeloma causes anemia by reversible disruption of erythropoiesis.

摘要: Multiple myeloma (MM) infiltrates bone marrow and causes anemia by disrupting erythropoiesis, but the effects of infiltration on are difficult to quantify. Marrow biopsies newly diagnosed MM patients were analyzed before after four 28-day cycles non-erythrotoxic remission induction chemotherapy. Complete blood cell counts serum paraprotein concentrations measured at diagnosis each chemotherapy cycle. At diagnosis, area infiltrated correlated negatively with hemoglobin, erythrocytes, erythroid cells. After successful chemotherapy, less than 30% had no change in these parameters, whereas more increased all three parameters. Clinical data used develop mathematical models niches terminal erythroblastic islands (EBIs). A hybrid discrete-continuous model erythropoiesis based EBI structure/function was extended sections containing multiple EBIs. In model, cells can kill physically destroying EBIs producing proapoptotic cytokines. Following changes paraproteins as measures erythrocyte numbers allowed modeling death recovery, respectively. Simulations treatment demonstrate that myeloma-mediated destruction subsequent reestablishment expansion populations following provide explanations for development its therapy-mediated recovery patients.