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DNA damage response in multiple myeloma and the tumor microenvironment. Tumor microenvironment factors, such as chemotherapeutic agents, inflammation, ROS, cytokines, genotoxic stress, and hypoxia, influence the DNA damage response in MM cells. The DNA damage response affects disease progression and drug resistance. ROS, reactive oxygen species; OC, osteoclast; BMSC, bone marrow stromal cell; MM Cell, multiple myeloma cell; SSBs, single-strand breaks; DSBs, double-strand breaks.
