The addition of CLL conditioned media, CLL sera or CLL cells to osteo-induced bone marrow stromal cells impairs mineralized matrix deposition, as revealed by Alizarine Red staining. (A, B) When CLL conditioned media (cm), CLL sera (sr) or CLL cells, in contact (co) or in transwell (tw), were added to bone marrow stromal cells (BMSC) induced to differentiate in standard osteogenic medium a reduced deposition of mineralized matrix was detected. This effect was particularly and significantly evident in the presence of CLL-cm or CLL-sr (P<0.001). (C, D) The inhibition of mineralized matrix deposition, due to the addition of CLL-cm derived from four CLL patients (FW16, LSA01, MS15, MAO2), was counteracted by neutralizing anti-TNFα, anti-IL-11 monoclonal antibodies (moAb) or anti-IL-6R,and anti- GP130 moAb. The anti-TNFα moAb infliximab showed a higher efficiency in restoring mineralization. (E, F) The addition of conditioned medium (cm) derived from cultures of IL-6-, IL-11-, or TNFα-silenced MEC-1 cells or leukemic CLL cells (BA101) restored mineralization by osteo-induced BMSC, as shown in a representative well of two assessed. (G, H) In parallel, neutralizing moAb for the same cytokines rescued matrix mineralization. Histogram bars depict the percentage of Alizarinepositive area of each well.