Evaluating the Relationship of GDF-15 with Clinical Characteristics, Cardinal Features, and Survival in Multiple Myeloma

Figure 5

The proposed graphical representation of the bone marrow environment in multiple myeloma and end-organ involvement: abnormal bone marrow stromal cells release growth factors, cytokines, and survival factors (including GDF-15) following interactions with malignant plasma cells, which leads to uncontrolled tumor growth and progression. GDF-15 is associated with the development of the cardinal features of myeloma (anemia, renal impairment, and bone lesions), and it may be a mediator of pathways related to the development and progression of these complications.