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. 2022 Jul 4;14(13):3271. doi: 10.3390/cancers14133271

Figure 1.

Figure 1

The route of the malignant plasma cell in its survival niche. Multiple myeloma disease trajectory is schematized. Upper panel, left, clinical C.R.A.B. (hypercalcemia, renal failure, anemia, and bone disease; additional diagnostic criteria S.Li.M.—sixty percent clonal bone marrow infiltration, ratio light chains involved/uninvolved greater than 100, more than one focal lesion detected with MRI) results from cell-extrinsic and MM-intrinsic factors, driving disease progression. Left side, bottom: germinal center with B cells, plasma cells, and follicular dendritic cells; top: immune-microenvironment infiltration (left) and scheme of multiple alterations building heterogeneous genomic architecture (right). MM: multiple myeloma; PMN: neutrophil granulocytes; BMSC: bone marrow stromal cell; EC: endothelial cell; MGUS: monoclonal gammopathy of undetermined significance; SMM: smoldering multiple myeloma; EMD: extramedullary disease; PCL: plasma cell leukemia. Created with BioRender.com.