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Waldenstrom’s Macroglobulinaemia: Immunosurveillance and the Immune Micro-environment

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Waldenström’s Macroglobulinemia

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Abstract

Understanding the interactions of the immune system and B-cell tumours has great therapeutic potential. Both in myeloma and Waldenstrom’s macroglobulinaemia (WM), there are measurable changes in the immune system with abnormalities of T-cells, NK cells and the ability to respond to external immunological stimuli. The homeostatic balance between the activation and suppression of immune antitumour effector cells in vivo is controlled by a network of cytokines and regulatory cells in a defined micro-environment. In myeloma, malignant plasma cells appear to have multiple mechanisms of inhibiting the antitumour immune response. These include inactivation of clonal cytotoxic T-cell, depression of NK and dendritic cell function and altering the regulatory T and pro-inflammatory Th17 cell balance in favour of a suppressive state. In addition, in myeloma, trogocytosis (demonstrated by malignant membrane transfer to T-cells) of plasma cells by T-lymphocytes results in the development of inhibitory Treg cells. In addition myeloid-derived suppressor cells (MDSC) are numerically increased, localised to the bone marrow micro-environment and functionally more active in patients with myeloma as compared to normal. The state of the immune homeostatic balance in WM has not yet been so clearly defined but results in the development of clonal cytotoxic T-cells, with possible abnormalities in Treg and Th17 populations and defects in NK cell function under active investigation.

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Authors and Affiliations

  1. Institute of Haematology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia

    D. E. Joshua, R. Brown, P. J. Ho, J. Gibson & H. Suen

  2. Sydney University Medical School, Sydney, NSW, Australia

    D. E. Joshua, R. Brown, P. J. Ho, J. Gibson & H. Suen

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  1. D. E. Joshua
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  2. R. Brown
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  3. P. J. Ho
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Correspondence to D. E. Joshua .

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Editors and Affiliations

  1. Haematology, Hôpital Pitié-Salpêtriêre, Paris, France

    Véronique Leblond

  2. Dana Farber Cancer Institute, Boston, Massachusetts, USA

    Steve Treon

  3. School of Medicine, University of Athens, Athens, Greece

    Meletios Dimoploulos

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Joshua, D.E., Brown, R., Ho, P.J., Gibson, J., Suen, H. (2017). Waldenstrom’s Macroglobulinaemia: Immunosurveillance and the Immune Micro-environment. In: Leblond, V., Treon, S., Dimoploulos, M. (eds) Waldenström’s Macroglobulinemia. Springer, Cham. https://doi.org/10.1007/978-3-319-22584-5_8

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