1. Chapter 80: Hematologic Malignancies and Bone
Wassim M. McHayleh, Jessica Ellerman, and G. David Roodman

2. From the Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, 7th Edition.
Figure 1
Figure 1 Vicious cycle of myeloma bone disease. Myeloma cells produce factors that directly or indirectly activate osteoclasts such as MIP-1α and IL-3. In addition, they induce RANKL and IL-6 production by marrow stromal cells to enhance osteoclast formation. The bone destructive process releases growth factors that increase the growth of myeloma cells, further exacerbating the osteolytic process. Myeloma cells also produce DKK1, IL-3, soluble frizzle-related protein-2, and IL-7, which suppress osteoblast differentiation and new bone formation.
Figure 1 Vicious cycle of myeloma bone disease. Myeloma cells produce factors that directly or indirectly activate osteoclasts such as MIP-1α and IL-3. In addition, they induce RANKL and IL-6 production by marrow stromal cells to enhance osteoclast formation. The bone destructive process releases growth factors that increase the growth of myeloma cells, further exacerbating the osteolytic process. Myeloma cells also produce DKK1, IL-3, soluble frizzle-related protein-2, and IL-7, which suppress osteoblast differentiation and new bone formation.