Bone marrow stromal-derived soluble factors and direct cell contact contribute to de novo drug resistance of myeloma cells by distinct mechanisms

Leukemia. 2003 Jun;17(6):1175-82. doi: 10.1038/sj.leu.2402924.


The tumor microenvironment plays a critical role in determining the fate of tumor cells. We have previously reported that adhesion of human myeloma and leukemia cell lines to the extracellular matrix protein, fibronectin, confers a multidrug-resistant phenotype. Mechanisms associated with this cell adhesion-mediated drug resistance are drug-type specific. In the present study, we examined the influence of bone marrow stromal cells (BMSCs) on myeloma cell response to the topoisomerase II inhibitor, mitoxantrone. Apoptosis was inhibited by more than 50% when cells were adhered to BMSCs as compared to myeloma cells maintained in suspension. To investigate the mechanisms contributing to the resistance of myeloma cells in contact with BMSCs, we examined the protective effects of BMSCs under four separate conditions: (1) direct cell contact; (2) BMSCs conditioned medium; (3) medium conditioned by coculturing myeloma cells in direct contact with BMSCs; and (4) medium conditioned by coculturing myeloma cells and BMSCs without direct physical contact. Conditioned medium from BMSCs alone was not sufficient to protect myeloma cells from drug-induced apoptosis; however, soluble factors produced during the myeloma-BMSCs interaction decreased the sensitivity of myeloma cells to mitoxantrone, suggesting a dynamic interaction between myeloma cells and BMSCs. We also found that myeloma cells in direct contact with BMSCs underwent growth arrest, whereas soluble factors produced by myeloma cells-BMSCs coincubation stimulated the proliferation of myeloma cells. These data show that both cell-cell adhesion of BMSCs with myeloma cells and soluble factors induced by this cell-cell interaction are involved in the protection of myeloma cells from mitoxantrone-induced apoptosis; however, the mechanisms contributing to the drug resistance are different.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • ADP-ribosyl Cyclase / metabolism
  • ADP-ribosyl Cyclase 1
  • Annexin A5 / metabolism
  • Antibodies, Monoclonal / pharmacology
  • Antigens, CD / metabolism
  • Antineoplastic Agents / pharmacology*
  • Apoptosis / drug effects*
  • Blotting, Western
  • Bone Marrow Cells / drug effects*
  • Bone Marrow Cells / metabolism
  • Cell Adhesion / drug effects
  • Cell Communication
  • Cell Cycle / drug effects
  • Cell Division / drug effects
  • Coculture Techniques
  • Culture Media, Conditioned
  • Drug Resistance, Neoplasm*
  • Endothelial Growth Factors / immunology
  • Endothelial Growth Factors / metabolism
  • Fibroblast Growth Factor 2 / metabolism
  • Humans
  • In Situ Nick-End Labeling
  • Integrins / immunology
  • Integrins / physiology
  • Intercellular Signaling Peptides and Proteins / immunology
  • Intercellular Signaling Peptides and Proteins / metabolism
  • Interleukin-6 / immunology
  • Interleukin-6 / metabolism
  • Lymphokines / immunology
  • Lymphokines / metabolism
  • Membrane Glycoproteins
  • Mitoxantrone / pharmacology*
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / metabolism
  • Ribonuclease, Pancreatic / metabolism
  • Stromal Cells / metabolism*
  • Tumor Cells, Cultured
  • Vascular Endothelial Growth Factor A
  • Vascular Endothelial Growth Factors


  • Annexin A5
  • Antibodies, Monoclonal
  • Antigens, CD
  • Antineoplastic Agents
  • Culture Media, Conditioned
  • Endothelial Growth Factors
  • Integrins
  • Intercellular Signaling Peptides and Proteins
  • Interleukin-6
  • Lymphokines
  • Membrane Glycoproteins
  • Vascular Endothelial Growth Factor A
  • Vascular Endothelial Growth Factors
  • Fibroblast Growth Factor 2
  • Mitoxantrone
  • Ribonuclease, Pancreatic
  • ADP-ribosyl Cyclase
  • CD38 protein, human
  • ADP-ribosyl Cyclase 1