Figure 1.

The vicious cycle of myeloma bone disease. The interactions between myeloma cells and cells of the bone marrow microenvironment, including stromal cells, osteoblasts and osteoclasts, promote both tumour growth and osteolytic bone disease. As our understanding of the mechanisms involved in disease pathogenesis increases, novel targets are revealed, which act on distinct components of the cycle to reduce tumour growth and/or bone disease.