Exploring the Bone Marrow Microenvironment’s Influence on NDMM Trajectory

In a conversation with CancerNetwork®, Manoj Bhasin, PhD, MS, spoke about findings from a study in which he and colleagues developed a single-cell atlas characterizing the dysregulation of the bone marrow immune microenvironment in newly diagnosed multiple myeloma. Findings published in Nature Cancer showed that the immune system has a broad, treatment-independent influence on outcomes in newly diagnosed multiple myeloma.

Bhasin began by detailing the background and methodology of his study, in which an Immune Atlas of multiple myeloma helped generate profiles of 1,397,272 single cells from the bone marrow of 337 patients with newly diagnosed disease to characterize immune and hematopoietic cell populations. He also broke down specific analyses of certain aspects of the immune microenvironment, such as signaling evaluations demonstrating active intercellular communication involving a proliferation-inducing ligand and B cell maturation antigen potentially associated with tumor growth and survival.

Looking ahead, Bhasin described a need to research additional factors, including those beyond the bone marrow, which may help clinicians further optimize therapeutic strategies for patients with multiple myeloma.

“Maybe the biggest thing we want to say from this study is that the immune system is a critical player in the outcome of multiple myeloma, its emergence, and its therapeutic response. It is not a byproduct; it is a major driver of the outcomes,” Bhasin stated. “[Not] all high-risk multiple myeloma lesions are the same. We should look at the immune imprints of them, further comprehensively study them, and then help in designing immune therapies that fix the immune dysregulation that is associated with each cytogenetic alteration [instead of] thinking that all high-risk cytogenetic lesions of myeloma are all the same.”

Bhasin is a professor in the Department of Pediatrics and in the Department of Biomedical Informatics at Emory University School of Medicine, and director of Genomics, Proteomics, Bioinformatics and Systems Biology and the Aflac Director of the Single Cell Biology Program at Children’s Healthcare of Atlanta.

Reference

Pilcher WC, Yao L, Gonzalez-Kozlova E, et al. A single-cell atlas characterizes dysregulation of the bone marrow immune microenvironment associated with outcomes in multiple myeloma. Nat Cancer. 2026;7:224-246. doi:10.1038/s43018-025-01072-4