{
  "abstract": "Multiple myeloma (MM) is increasingly understood as a spatially organized and dynamically evolving disease, in which malignant plasma-cell behavior is shaped by local immune, stromal, vascular, and metabolic contexts. Single-cell, spatial, and multi-omic technologies have resolved tumor-cell heterogeneity, bone marrow niche remodeling, immune dysfunction, and therapy-induced selection at unprecedented resolution, yet an integrated synthesis linking marrow architecture, extramedullary dissemination, circulating tumor cells, metabolic reprogramming, chimeric antigen receptor T (CAR-T) cell and T-cell-redirecting immunotherapy, and stem-cell transplantation remains lacking. Here, we review how malignant subclones occupy distinct marrow regions, focal lesions, and extramedullary sites with different transcriptional, antigenic, immune-interactive, and metabolic states. We discuss how spatial transcriptomics and multiplexed imaging reveal immune exclusion, stromal support, oxidative and glycolytic niches, and region-specific antigen heterogeneity. We further examine how circulating tumor cells serve as liquid readouts of tumor burden, high-risk genomics, and clonal evolution. Emphasis is placed on CAR T-cell and T-cell engager therapies, where response and resistance depend on antigen retention, effector-cell fitness, clonal T-cell expansion, myeloid suppression, and spatial accessibility. Finally, we consider autologous hematopoietic stem-cell transplantation as a clinical model of cytoreduction, lymphodepletion, and incomplete immune reconstitution. We propose that MM progression and relapse should be interpreted through an integrated spatial-temporal framework, in which therapeutic outcome reflects the interaction between malignant plasma-cell plasticity, immune competence, stromal persistence, metabolic adaptation, and residual disease localization.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel.",
    "Jerusalem Multidisciplinary College, Jerusalem 9101001, Israel."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Katia Beider",
      "orcid": "0000-0001-7739-7745"
    },
    {
      "affs": [
        0
      ],
      "name": "Olga Ostrovsky"
    },
    {
      "affs": [
        0
      ],
      "name": "Arnon Nagler",
      "orcid": "0000-0002-0763-1265"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4259ntbfta87f.bib",
  "cited_by": 0,
  "doi": "10.3390/cancers18193158",
  "fulltext_url": "https://europepmc.org/articles/PMC13664374",
  "id": "4259ntbfta87f",
  "issns": [
    "2072-6694"
  ],
  "landing_url": "https://europepmc.org/article/MED/42882852",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2720|Multiple Myeloma Research and Treatments"
    ]
  ],
  "openalex": "W7214733579",
  "pdf_url": "https://europepmc.org/articles/PMC13664374?pdf=render",
  "pmcid": "PMC13664374",
  "pmid": "42882852",
  "published": "2026-09-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4259ntbfta87f.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:16Z",
      "native_id": "MED:42882852",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42882852"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2072-6694",
      "subfield": "oncology"
    }
  ],
  "title": "Single-Cell and Multi-Omics Profiling of the Multiple Myeloma Immune Niche: From Bone Marrow Architecture and Metabolic Reprogramming to Immunotherapy Response.",
  "title_text": "Single-Cell and Multi-Omics Profiling of the Multiple Myeloma Immune Niche: From Bone Marrow Architecture and Metabolic Reprogramming to Immunotherapy Response.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:16Z",
  "url": "https://research.draconitic.com/paper/4259ntbfta87f",
  "venue": "Cancers",
  "versions": []
}