Osteoclast-like cell formation by circulating myeloma B lymphocytes: role of RANK-L.

Excessive bone resorption in multiple myeloma (MM), a malignancy of B lymphoid origin, is mediated through osteoclasts, which respond to local osteoclast-activating factors produced by tumor cells within the bone marrow microenvironment. Direct bone resorption by myeloma cells is investigated in the present study, since a connection between B lymphocytes and osteoclast differentiation pathways has been recently postulated in mice. Peripheral CD19+ B lymphocytes isolated from 10 myeloma patients with multiple osteolytic lesions and 10 healthy donors were cultured in the presence of M-CSF and RANK-L, two major osteoclast-activating factors. The TRAP expression and resorption of bone substrates were employed to evaluate osteoclast differentiation. MM patients were characterized by the presence of circulating B lymphocytes endowed with both phenotypical and functional properties of osteoclast-like cells in vitro when stimulated with RANK-L. The absence of these characteristics in B lymphocytes from healthy donors indicates that the transformation can be ascribed to the presence of clonogenic B cells in patients with MM. Clonotypic B lymphocytes may contribute to the pathogenesis of bone disease in MM by acting as RANK-L-dependent osteoclast progenitors.