Cutaneous localization in multiple myeloma in the context of bortezomib-based treatment: how do myeloma cells escape from the bone marrow to the skin?

Int J Hematol. 2017 Jan;105(1):104-108. doi: 10.1007/s12185-016-2104-1. Epub 2016 Oct 3.


The skin is a possible site of extramedullary localization in multiple myeloma (MM) patients; however, the mechanisms involved in this process are poorly understood. We describe the case of a refractory MM patient who developed a cutaneous localization under bortezomib treatment and we further expanded observations in other eight MM patients. We focused on the expression of genes involved in plasma cell skin homing, including CCR10, which was highly expressed. Moreover, we observed a lack of CXCR4 surface expression and the down-regulation of ICAM1/CD54 throughout the progression of the disease, suggesting a possible mechanism driving the escape of MM cells from the bone marrow into the skin.

Keywords: Bone marrow; Extramedullary disease; Multiple myeloma; Skin homing.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Bone Marrow / drug effects
  • Bone Marrow / pathology*
  • Bortezomib / therapeutic use*
  • Down-Regulation
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Intercellular Adhesion Molecule-1 / genetics
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / genetics
  • Multiple Myeloma / pathology*
  • Plasma Cells / drug effects
  • Plasma Cells / pathology*
  • Plasmacytoma / genetics
  • Plasmacytoma / pathology
  • Plasmacytoma / secondary*
  • Receptors, CXCR4 / genetics
  • Skin / pathology*
  • Skin Neoplasms / genetics
  • Skin Neoplasms / pathology
  • Skin Neoplasms / secondary*


  • Antineoplastic Agents
  • CXCR4 protein, human
  • ICAM1 protein, human
  • Receptors, CXCR4
  • Intercellular Adhesion Molecule-1
  • Bortezomib