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The role of the bone marrow microenvironment in the myeloma plasma cell dormancy and reactivation – toward a cure for myeloma

Prof Andrew Zannettino, Prof. Peter Croucher, Dr Kyohei Nakamura,  SAHMRI, Garvan Institute, QMIR Berghofer

Multiple myeloma (MM) is a blood cancer of cells of the immune system, known as plasma cells. Normally, plasma cells help us fight infection by making proteins, known as antibodies. When plasma cells become cancerous, they grow within the bone marrow in an uncontrolled way and affect normal blood cell production.

Multiple myeloma is one of the most common blood cancers affecting more than 140,000 people worldwide annually and remains largely incurable. In recent years, a large number of new drugs have been developed to treat MM, which has seen MM patients living longer without evidence of disease. Unfortunately, despite these improvements, essentially all MM patients will stop responding to therapy at some stage and will experience relapse. Recent evidence suggests that relapse occurs because of a population of cancer cells that appear to be dormant or in a “sleep like” state, which are hidden away or ‘buried’ within the bone marrow. These dormant cells persist following therapy and can be reactivated or ‘woken-up’ to grow at a later stage, leading to disease relapse. To cure myeloma, it is therefore essential to kill these rare, therapy-resistant dormant cells.

Headed by Professor Andrew Zannettino (University of Adelaide and South Australian Health and Medical Research Institute [SAHMRI], South Australia) and Professor Peter Croucher (The Garvan Institute of Medical Research, New South Wales), this project brings together leading researchers from medical research institutes in 3 states of Australia. The team are experts in cancer cell dormancy, the role of the immune system in cancer control and how the cancer cell environment of the bone marrow contributes to cancer growth. This research will identify new markers of MM cancer cell dormancy that will be used to specify which types of treatments are likely to have the most favourable clinical outcomes for MM patients.

This project is kindly supported by the Estate of Davina Sickerdick.