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The B-cell receptor orchestrates environment-mediated lymphoma survival and drug resistance in B-cell malignancies

Abstract

Specific niches within the lymphoma tumor microenvironment (TME) provide sanctuary for subpopulations of tumor cells through stromal cell–tumor cell interactions. These interactions notably dictate growth, response to therapy and resistance of residual malignant B cells to therapeutic agents. This minimal residual disease (MRD) remains a major challenge in the treatment of B-cell malignancies and contributes to subsequent disease relapse. B-cell receptor (BCR) signaling has emerged as essential mediator of B-cell homing, survival and environment-mediated drug resistance (EMDR). Central to EMDR are chemokine- and integrin-mediated interactions between lymphoma and the TME. Further, stromal cell–B cell adhesion confers a sustained BCR signaling leading to chemokine and integrin activation. Recently, the inhibitors of BCR signaling have garnered a substantial clinical interest because of their effectiveness in B-cell disorders. The efficacy of these agents is, at least in part, attributed to attenuation of BCR-dependent lymphoma–TME interactions. In this review, we discuss the pivotal role of BCR signaling in the integration of intrinsic and extrinsic determinants of TME-mediated lymphoma survival and drug resistance.

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References

  1. Lwin T, Crespo LA, Wu A, Dessureault S, Shu HB, Moscinski LC et al. Lymphoma cell adhesion-induced expression of B cell-activating factor of the TNF family in bone marrow stromal cells protects non-Hodgkin’s B lymphoma cells from apoptosis. Leukemia 2009; 23: 170–177.

    CAS  PubMed  Google Scholar 

  2. Shain KH, Yarde DN, Meads MB, Huang M, Jove R, Hazlehurst LA et al. Beta1 integrin adhesion enhances IL-6-mediated STAT3 signaling in myeloma cells: implications for microenvironment influence on tumor survival and proliferation. Cancer Res 2009; 69: 1009–1015.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. McMillin DW, Delmore J, Weisberg E, Negri JM, Geer DC, Klippel S et al. Tumor cell-specific bioluminescence platform to identify stroma-induced changes to anticancer drug activity. Nat Med 2010; 16: 483–489.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Hall BM, Gibson LF . Regulation of lymphoid and myeloid leukemic cell survival: role of stromal cell adhesion molecules. Leukemia Lymphoma 2004; 45: 35–48.

    CAS  PubMed  Google Scholar 

  5. Woyach JA, Johnson AJ, Byrd JC . The B-cell receptor signaling pathway as a therapeutic target in CLL. Blood 2012; 120: 1175–1184.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Burger JA . Targeting the microenvironment in chronic lymphocytic leukemia is changing the therapeutic landscape. Curr Opin Oncol 2012; 24: 643–649.

    CAS  PubMed  Google Scholar 

  7. Azab AK, Runnels JM, Pitsillides C, Moreau AS, Azab F, Leleu X et al. CXCR4 inhibitor AMD3100 disrupts the interaction of multiple myeloma cells with the bone marrow microenvironment and enhances their sensitivity to therapy. Blood 2009; 113: 4341–4351.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Burger JA, Ghia P, Rosenwald A, Caligaris-Cappio F . The microenvironment in mature B-cell malignancies: a target for new treatment strategies. Blood 2009; 114: 3367–3375.

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Byrd JC . Therapeutic targeting of B-cell receptor signaling pathways. Blood 2012; 120: 21.

    Google Scholar 

  10. Tai YT, Chang BY, Kong SY, Fulciniti M, Yang G, Calle Y et al. Bruton tyrosine kinase inhibition is a novel therapeutic strategy targeting tumor in the bone marrow microenvironment in multiple myeloma. Blood 2012; 120: 1877–1887.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Spaargaren M, Beuling EA, Rurup ML, Meijer HP, Klok MD, Middendorp S et al. The B cell antigen receptor controls integrin activity through Btk and PLC gamma 2. J Exper Med 2003; 198: 1539–1550.

    CAS  Google Scholar 

  12. Herreros B, Sanchez-Aguilera A, Piris MA . Lymphoma microenvironment: culprit or innocent? Leukemia 2008; 22: 49–58.

    CAS  PubMed  Google Scholar 

  13. Staudt LM . Chronic active B-cell receptor signaling in lymphoma. ASH Annual Meeting Abstracts 2012; 120 (21): SCI-26-.

    Google Scholar 

  14. Hall BM, Fortney JE, Taylor L, Wood H, Wang L, Adams S et al. Stromal cells expressing elevated VCAM-1 enhance survival of B lineage tumor cells. Cancer Lett 2004; 207: 229–239.

    CAS  PubMed  Google Scholar 

  15. Young RM, Staudt LM . Targeting pathological B cell receptor signalling in lymphoid malignancies. Nat Rev Drug Discov 2013; 12: 229–243.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Cheng PC, Dykstra ML, Mitchell RN, Pierce SK . A role for lipid rafts in B cell antigen receptor signaling and antigen targeting. J Exper Med 1999; 190: 1549–1560.

    CAS  Google Scholar 

  17. Buchner M, Fuchs S, Prinz G, Pfeifer D, Bartholome K, Burger M et al. Spleen tyrosine kinase is overexpressed and represents a potential therapeutic target in chronic lymphocytic leukemia. Cancer Res 2009; 69: 5424–5432.

    CAS  PubMed  Google Scholar 

  18. Saito K, Tolias KF, Saci A, Koon HB, Humphries LA, Scharenberg A et al. BTK regulates PtdIns-4,5-P2 synthesis: importance for calcium signaling and PI3K activity. Immunity 2003; 19: 669–678.

    CAS  PubMed  Google Scholar 

  19. Zhang L, Yang J, Qian J, Li H, Romaguera JE, Kwak LW et al. Role of the microenvironment in mantle cell lymphoma: IL-6 is an important survival factor for the tumor cells. Blood 2012; 120: 3783–3792.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Lam KP, Rajewsky K . Rapid elimination of mature autoreactive B cells demonstrated by Cre-induced change in B cell antigen receptor specificity in vivo. Proc Natl Acad Sci USA 1998; 95: 13171–13175.

    CAS  PubMed  PubMed Central  Google Scholar 

  21. Davis RE, Ngo VN, Lenz G, Tolar P, Young RM, Romesser PB et al. Chronic active B-cell-receptor signalling in diffuse large B-cell lymphoma. Nature 2010; 463: 88–U97.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. de Gorter DJJ, Beuling EA, Kersseboom R, Middendorp S, van Gils JM, Hendriks RW et al. Bruton’s tyrosine kinase and phospholipase C gamma 2 mediate chemokine-controlled B cell migration and homing. Immunity 2007; 26: 93–104.

    CAS  PubMed  Google Scholar 

  23. Herman SEM, Farooqui M, Bezabhie R, Aue G, Wiestner A . In vivo effects of ibrutinib on BCR signaling, tumor cell activation and proliferation in blood and tissue-resident cells of chronic lymphocytic leukemia patients. ASH Annual Meeting Abstracts 2012; 120: 185.

    Google Scholar 

  24. Hoellenriegel J, Coffey GP, Sinha U, Pandey A, Sivina M, Ferrajoli A et al. Selective, novel spleen tyrosine kinase (Syk) inhibitors suppress chronic lymphocytic leukemia B-cell activation and migration. Leukemia 2012; 26: 1576–1583.

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Kurtova AV, Balakrishnan K, Chen R, Ding W, Schnabl S, Quiroga MP et al. Diverse marrow stromal cells protect CLL cells from spontaneous and drug-induced apoptosis: development of a reliable and reproducible system to assess stromal cell adhesion-mediated drug resistance. Blood 2009; 114: 4441–4450.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Hoellenriegel J, O′Brien S, Keating MJ, Wierda WG, Buggy JJ, Burger JA . In vivo inhibition of BCR activation in high-risk CLL patients on therapy with Bruton’s tyrosine kinase inhibitor ibrutinib: correlative studies from an ongoing phase 2 clinical trial. ASH Annual Meeting Abstracts 2012; 120: 186.

    Google Scholar 

  27. Hoellenriegel J, Meadows SA, Sivina M, Wierda WG, Kantarjian H, Keating MJ et al. The phosphoinositide 3'-kinase delta inhibitor, CAL-101, inhibits B-cell receptor signaling and chemokine networks in chronic lymphocytic leukemia. Blood 2011; 118: 3603–3612.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Vij R, Chang BY, Berdeja JG, Huff CA, Lendvai N, Tai YT et al. Early changes in cytokines, chemokines and indices of bone metabolism in a phase 2 study of the bruton tyrosine kinase (Btk) inhibitor, ibrutinib (PCI-32765) in patients with relapsed or relapsed/refractory multiple myeloma (MM). Blood 2012; 120: 21.

    Google Scholar 

  29. Burger JA, Kipps TJ . CXCR4: a key receptor in the crosstalk between tumor cells and their microenvironment. Blood 2006; 107: 1761–1767.

    CAS  PubMed  Google Scholar 

  30. Teicher BA, Fricker SP . CXCL12 (SDF-1)/CXCR4 pathway in cancer. Clin Cancer Res 2010; 16: 2927–2931.

    CAS  PubMed  Google Scholar 

  31. Azab AK, Azab F, Blotta S, Pitsillides CM, Thompson B, Runnels JM et al. Rho-A and Rac-1 GTPases play major and differential roles in SDF1-induced cell adhesion and chemotaxis in multiple myeloma. Blood 2009; 114: 619–629.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Ngo HT, Leleu X, Lee J, Jia X, Melhem M, Runnels J et al. SDF-1/CXCR4 and VLA-4 interaction regulates homing in Waldenstrom macroglobulinemia. Blood 2008; 112: 150–158.

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Sanz-Rodriguez F, Hidalgo A, Teixido J . Chemokine stromal cell-derived factor-1alpha modulates VLA-4 integrin-mediated multiple myeloma cell adhesion to CS-1/fibronectin and VCAM-1. Blood 2001; 97: 346–351.

    CAS  PubMed  Google Scholar 

  34. Arana E, Harwood NE, Batista FD . Regulation of integrin activation through the B-cell receptor. J Cell Sci 2008; 121 (Pt 14): 2279–2286.

    CAS  PubMed  Google Scholar 

  35. Shapiro-Shelef M, Calame K . Regulation of plasma-cell development. Nat Rev Immunol 2005; 5: 230–242.

    CAS  PubMed  Google Scholar 

  36. Azab AK, Hu J, Quang P, Azab F, Pitsillides C, Awwad R et al. Hypoxia promotes dissemination of multiple myeloma through acquisition of endothelial to mesenchymal transition-like features. Blood 2012; 119: 5782–5794.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Takagi J, Petre BM, Walz T, Springer TA . Global conformational rearrangements in integrin extracellular domains in outside-in and inside-out signaling. Cell 2002; 110: 599–11.

    CAS  PubMed  Google Scholar 

  38. Xiong JP, Stehle T, Diefenbach B, Zhang R, Dunker R, Scott DL et al. Crystal structure of the extracellular segment of integrin alpha Vbeta3. Science 2001; 294: 339–345.

    CAS  PubMed  PubMed Central  Google Scholar 

  39. Grzesiak JJ, Smith KC, Burton DW, Deftos LJ, Bouvet M . Integrin-mediated laminin-1 adhesion upregulates CXCR4 and IL-8 expression in pancreatic cancer cells. Surgery 2007; 141: 804–814.

    PubMed  Google Scholar 

  40. Quiroga MP, Balakrishnan K, Kurtova AV, Sivina M, Keating MJ, Wierda WG et al. B-cell antigen receptor signaling enhances chronic lymphocytic leukemia cell migration and survival: specific targeting with a novel spleen tyrosine kinase inhibitor, R406. Blood 2009; 114: 1029–1037.

    CAS  PubMed  PubMed Central  Google Scholar 

  41. McCaig AM, Cosimo E, Leach MT, Michie AM . Dasatinib inhibits CXCR4 signaling in chronic lymphocytic leukaemia cells and impairs migration towards CXCL12. PLoS One 2012; 7: e48929.

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Carrasco YR, Batista FD . B-cell activation by membrane-bound antigens is facilitated by the interaction of VLA-4 with VCAM-1. EMBO J 2006; 25: 889–899.

    CAS  PubMed  PubMed Central  Google Scholar 

  43. Niedermeier M, Hennessy BT, Knight ZA, Henneberg M, Hu J, Kurtova AV et al. Isoform-selective phosphoinositide 3'-kinase inhibitors inhibit CXCR4 signaling and overcome stromal cell-mediated drug resistance in chronic lymphocytic leukemia: a novel therapeutic approach. Blood 2009; 113: 5549–5557.

    CAS  PubMed  PubMed Central  Google Scholar 

  44. de Rooij MFM, Kuil A, Geest CR, Eldering E, Chang BY, Buggy JJ et al. The clinically active BTK inhibitor PCI-32765 targets B-cell receptor- and chemokine-controlled adhesion and migration in chronic lymphocytic leukemia. Blood 2012; 119: 2590–2594.

    CAS  PubMed  Google Scholar 

  45. Do RK, Hatada E, Lee H, Tourigny MR, Hilbert D, Chen-Kiang S . Attenuation of apoptosis underlies B lymphocyte stimulator enhancement of humoral immune response. J Exper Med 2000; 192: 953–964.

    CAS  Google Scholar 

  46. Bossen C, Cachero TG, Tardivel A, Ingold K, Willen L, Dobles M et al. TACI, unlike BAFF-R, is solely activated by oligomeric BAFF and APRIL to support survival of activated B cells and plasmablasts. Blood 2008; 111: 1004–1012.

    CAS  PubMed  Google Scholar 

  47. Gross JA, Johnston J, Mudri S, Enselman R, Dillon SR, Madden K et al. TACI and BCMA are receptors for a TNF homologue implicated in B-cell autoimmune disease. Nature 2000; 404: 995–999.

    CAS  PubMed  Google Scholar 

  48. Khare SD, Sarosi I, Xia XZ, McCabe S, Miner K, Solovyev I et al. Severe B cell hyperplasia and autoimmune disease in TALL-1 transgenic mice. Proc Natl Acad Sci USA 2000; 97: 3370–3375.

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Mackay F, Woodcock SA, Lawton P, Ambrose C, Baetscher M, Schneider P et al. Mice transgenic for BAFF develop lymphocytic disorders along with autoimmune manifestations. J Exper Med 1999; 190: 1697–1710.

    CAS  Google Scholar 

  50. Vora KA, Wang LC, Rao SP, Liu ZY, Majeau GR, Cutler AH et al. Cutting edge: germinal centers formed in the absence of B cell-activating factor belonging to the TNF family exhibit impaired maturation and function. J Immunol 2003; 171: 547–551.

    CAS  PubMed  Google Scholar 

  51. Kern C, Cornuel JF, Billard C, Tang R, Rouillard D, Stenou V et al. Involvement of BAFF and APRIL in the resistance to apoptosis of B-CLL through an autocrine pathway. Blood 2004; 103: 679–688.

    CAS  PubMed  Google Scholar 

  52. Moreaux J, Legouffe E, Jourdan E, Quittet P, Reme T, Lugagne C et al. BAFF and APRIL protect myeloma cells from apoptosis induced by interleukin 6 deprivation and dexamethasone. Blood 2004; 103: 3148–3157.

    CAS  PubMed  Google Scholar 

  53. Medina DJ, Goodell L, Glod J, Gelinas C, Rabson AB, Strair RK . Mesenchymal stromal cells protect mantle cell lymphoma cells from spontaneous and drug-induced apoptosis through secretion of B-cell activating factor and activation of the canonical and non-canonical nuclear factor kappaB pathways. Haematologica 2012; 97: 1255–1263.

    CAS  PubMed  PubMed Central  Google Scholar 

  54. Schweighoffer E, Vanes L, Nys J, Cantrell D, McCleary S, Smithers N et al. The BAFF receptor transduces survival signals by co-opting the B cell receptor signaling pathway. Immunity 2013; 38: 475–488.

    CAS  PubMed  PubMed Central  Google Scholar 

  55. Lichtenstein A, Tu Y, Fady C, Vescio R, Berenson J . Interleukin-6 inhibits apoptosis of malignant plasma cells. Cell Immunol 1995; 162: 248–255.

    CAS  PubMed  Google Scholar 

  56. Lu Y, Zhang J, Dai J, Dehne LA, Mizokami A, Yao Z et al. Osteoblasts induce prostate cancer proliferation and PSA expression through interleukin-6-mediated activation of the androgen receptor. Clin Exper Metastasis 2004; 21: 399–408.

    CAS  Google Scholar 

  57. Gilbert LA, Hemann MT . Context-specific roles for paracrine IL-6 in lymphomagenesis. Genes Dev 2012; 26: 1758–1768.

    CAS  PubMed  PubMed Central  Google Scholar 

  58. Gilbert LA, Hemann MT . DNA damage-mediated induction of a chemoresistant niche. Cell 2010; 143: 355–366.

    CAS  PubMed  PubMed Central  Google Scholar 

  59. Thiel S, Sommer U, Kortylewski M, Haan C, Behrmann I, Heinrich PC et al. Termination of IL-6-induced STAT activation is independent of receptor internalization but requires de novo protein synthesis. FEBS Lett 2000; 470: 15–19.

    CAS  PubMed  Google Scholar 

  60. Catlett-Falcone R, Landowski TH, Oshiro MM, Turkson J, Levitzki A, Savino R et al. Constitutive activation of Stat3 signaling confers resistance to apoptosis in human U266 myeloma cells. Immunity 1999; 10: 105–115.

    CAS  PubMed  Google Scholar 

  61. Baran-Marszak F, Boukhiar M, Harel S, Laguillier C, Roger C, Gressin R et al. Constitutive and B-cell receptor-induced activation of STAT3 are important signaling pathways targeted by bortezomib in leukemic mantle cell lymphoma. Haematologica 2010; 95: 1865–1872.

    CAS  PubMed  PubMed Central  Google Scholar 

  62. Damiano JS, Cress AE, Hazlehurst LA, Shtil AA, Dalton WS . Cell adhesion mediated drug resistance (CAM-DR): role of integrins and resistance to apoptosis in human myeloma cell lines. Blood 1999; 93: 1658–1667.

    CAS  PubMed  Google Scholar 

  63. Shain KH, Dalton WS . Environmental-mediated drug resistance: a target for multiple myeloma therapy. Expert Rev Hematol 2009; 2: 649–662.

    CAS  PubMed  Google Scholar 

  64. de la Fuente MT, Casanova B, Garcia-Gila M, Silva A, Garcia-Pardo A . Fibronectin interaction with alpha4beta1 integrin prevents apoptosis in B cell chronic lymphocytic leukemia: correlation with Bcl-2 and Bax. Leukemia 1999; 13: 266–274.

    CAS  PubMed  Google Scholar 

  65. Pedersen IM, Kitada S, Leoni LM, Zapata JM, Karras JG, Tsukada N et al. Protection of CLL B cells by a follicular dendritic cell line is dependent on induction of Mcl-1. Blood 2002; 100: 1795–1801.

    CAS  PubMed  Google Scholar 

  66. Lwin T, Hazlehurst LA, Li Z, Dessureault S, Sotomayor E, Moscinski LC et al. Bone marrow stromal cells prevent apoptosis of lymphoma cells by upregulation of anti-apoptotic proteins associated with activation of NF-kappaB (RelB/p52) in non-Hodgkin’s lymphoma cells. Leukemia 2007; 21: 1521–1531.

    CAS  PubMed  Google Scholar 

  67. Landowski TH, Olashaw NE, Agrawal D, Dalton WS . Cell adhesion-mediated drug resistance (CAM-DR) is associated with activation of NF-kappa B (RelB/p50) in myeloma cells. Oncogene 2003; 22: 2417–2421.

    CAS  PubMed  Google Scholar 

  68. Shain KH, Dalton WS . Cell adhesion is a key determinant in de novo multidrug resistance (MDR): new targets for the prevention of acquired MDR. Mol Cancer Ther 2001; 1: 69–78.

    CAS  PubMed  Google Scholar 

  69. Perez LE, Parquet N, Shain K, Nimmanapalli R, Alsina M, Anasetti C et al. Bone marrow stroma confers resistance to Apo2 ligand/TRAIL in multiple myeloma in part by regulating c-FLIP. J Immunol 2008; 180: 1545–1555.

    CAS  PubMed  Google Scholar 

  70. Hazlehurst LA, Damiano JS, Buyuksal I, Pledger WJ, Dalton WS . Adhesion to fibronectin via beta1 integrins regulates p27kip1 levels and contributes to cell adhesion mediated drug resistance (CAM-DR). Oncogene 2000; 19: 4319–4327.

    CAS  PubMed  Google Scholar 

  71. Lwin T, Hazlehurst LA, Dessureault S, Lai R, Bai W, Sotomayor E et al. Cell adhesion induces p27Kip1-associated cell-cycle arrest through down-regulation of the SCFSkp2 ubiquitin ligase pathway in mantle-cell and other non-Hodgkin B-cell lymphomas. Blood 2007; 110: 1631–1638.

    CAS  PubMed  PubMed Central  Google Scholar 

  72. Hallek M, Neumann C, Schaffer M, Danhauser-Riedl S, von Bubnoff N, de Vos G et al. Signal transduction of interleukin-6 involves tyrosine phosphorylation of multiple cytosolic proteins and activation of Src-family kinases Fyn, Hck, and Lyn in multiple myeloma cell lines. Exper Hematol 1997; 25: 1367–1377.

    CAS  Google Scholar 

  73. de Gorter DJJ, Vos JCM, Pals ST, Spaargaren M . The B cell antigen receptor controls AP-1 and NFAT activity through Ras-mediated activation of Ral. J Immunol 2007; 178: 1405–1414.

    CAS  PubMed  Google Scholar 

  74. Ikeda H, Hideshima T, Fulciniti M, Perrone G, Miura N, Yasui H et al. PI3K/p110{delta} is a novel therapeutic target in multiple myeloma. Blood 2010; 116: 1460–1468.

    CAS  PubMed  PubMed Central  Google Scholar 

  75. Rushworth SA, Bowles KM, Barrera LN, Murray MY, Zaitseva L, MacEwan DJ . BTK inhibitor ibrutinib is cytotoxic to myeloma and potently enhances bortezomib and lenalidomide activities through NF-kappaB. Cell Signal 2013; 25: 106–112.

    CAS  PubMed  Google Scholar 

  76. Friedberg JW, Sharman J, Sweetenham J, Johnston PB, Vose JM, Lacasce A et al. Inhibition of Syk with fostamatinib disodium has significant clinical activity in non-Hodgkin lymphoma and chronic lymphocytic leukemia. Blood 2010; 115: 2578–2585.

    CAS  PubMed  PubMed Central  Google Scholar 

  77. Advani RH, Buggy JJ, Sharman JP, Smith SM, Boyd TE, Grant B et al. Bruton tyrosine kinase inhibitor ibrutinib (PCI-32765) has significant activity in patients with relapsed/refractory B-cell malignancies. J Clin Oncol 2013; 31: 88–94.

    CAS  PubMed  Google Scholar 

  78. Lannutti BJ, Meadows SA, Herman SE, Kashishian A, Steiner B, Johnson AJ et al. CAL-101, a p110delta selective phosphatidylinositol-3-kinase inhibitor for the treatment of B-cell malignancies, inhibits PI3K signaling and cellular viability. Blood 2011; 117: 591–594.

    CAS  PubMed  PubMed Central  Google Scholar 

  79. Stein R, Gupta P, Chen X, Cardillo TM, Furman RR, Chen S et al. Therapy of B-cell malignancies by anti-HLA-DR humanized monoclonal antibody, IMMU-114, is mediated through hyperactivation of ERK and JNK MAP kinase signaling pathways. Blood 2010; 115: 5180–5190.

    CAS  PubMed  PubMed Central  Google Scholar 

  80. McCarthy PL, Owzar K, Hofmeister CC, Hurd DD, Hassoun H, Richardson PG et al. Lenalidomide after stem-cell transplantation for multiple myeloma. N Eng J Med 2012; 366: 1770–1781.

    CAS  Google Scholar 

  81. Attal M, Lauwers-Cances V, Marit G, Caillot D, Moreau P, Facon T et al. Lenalidomide maintenance after stem-cell transplantation for multiple myeloma. N Eng J Med 2012; 366: 1782–1791.

    CAS  Google Scholar 

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Shain, K., Tao, J. The B-cell receptor orchestrates environment-mediated lymphoma survival and drug resistance in B-cell malignancies. Oncogene 33, 4107–4113 (2014). https://doi.org/10.1038/onc.2013.379

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