The Bone Marrow Microenvironment: Niche Biology and Its Exploitation in Malignancy

This chapter explores the complex cellular and molecular architecture of the bone marrow niche and the mechanisms by which malignant hematopoietic cells co-opt the microenvironment to support their survival, immune evasion, and drug resistance. It reviews the roles of mesenchymal stromal cells, osteoblasts, endothelial cells, and immune effectors in modulating hematopoietic stem cell fate and the progression of myeloid and lymphoid malignancies. The chapter addresses therapeutic strategies directed at disrupting malignancy-supportive niche interactions, including anti-CXCL12/CXCR4 axis agents and hypoxia-targeting approaches, as well as their preclinical and early clinical evidence.