Single Cell Analysis of the Tumor Microenvironment Landscape Across the Disease Spectrum of Multiple Myeloma

M Minghao Dang L Luz Yurany Moreno Rueda (The University of Texas MD Anderson Cancer Center, Houston, Texas, United States) M Maria Jose Acevedo Calado (The University of Texas MD Anderson Cancer Center, Houston, Texas, United States) H Hima Bansal (The University of Texas MD Anderson Cancer Center, Houston, Texas, United States) D David Alejandro Berrios Nolasco (The University of Texas MD Anderson Cancer Center, Houston, Texas, United States) A Amishi U Vora (The University of Texas MD Anderson Cancer Center, Houston, Texas, United States) J Jonathan D Mejia (The University of Texas MD Anderson Cancer Center, Houston, Texas, United States) M Mei Huang W Wei Tan L Li Qin Y Yunhe Liu Y Yang Liu D David E. Mery (University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States) Y Yan Cheng (Key Laboratory of Polar Materials and Devices (MOE), School of Information and Electronic Engineering (School of Integrated Circuits Science and Engineering), East China Normal University, Shanghai, China.)  Fenghuang  Zhan (University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States) J John D. Shaughnessy (University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States) Q Qing Yi P Pei Lin M Mahmoud R. Gaballa (The University of Texas MD Anderson Cancer Center, Houston, Texas, United States) O Oren Pasvolsky (The University of Texas MD Anderson Cancer Center, Houston, Texas, United States) H Hans C. Lee (1Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX) S Sheeba K. Thomas (M.D. Anderson Cancer Center, Houston, Texas, United States) D Donna M Weber (University of Texas, Houston, Texas, United States) K Krina K. Patel (The University of Texas, MD Anderson Cancer Center, Houston, Texas, United States) M Melody R Becnel (MD Anderson Cancer Center, houston, Texas, United States) J Jing Christine Ye (M.D. Anderson Cancer Center, University of Texas, Houston) I Isere Kuiatse (The University of Texas M. D. Anderson Cancer Center) E Elisabet E Manasanch (Regeneron Pharmaceuticals, Warren, New Jersey, United States) L Linghua Wang R Robert Z. Orlowski (The University of Texas MD Anderson Cancer Center, Houston, Texas, United States)

Abstract

Multiple myeloma progresses from precursor states to active disease, and studying tumor microenvironment (TME) evolution across these stages is key to understanding immune dysregulation and therapeutic resistance. Here, we integrated paired single-cell RNA, T-, and B-cell receptor sequencing data from bone marrow samples of 235 patients spanning the disease spectrum. This dataset revealed dynamic changes in the abundance and functional states of diverse immune populations, including T-, natural killer, B-, and myeloid cells. Using non-negative factorization of cell-subset composition, we identified five reproducible TME subtypes, or "ecotypes," defined by coordinated cellular architectures. These ecotypes captured structured variation beyond disease stage and were associated with distinct cell-cell communication networks, cytokine signaling landscapes, transcription factor programs, and shared gene modules, reflecting coordinated immune adaptation to microenvironmental constraints. By linking tumor features with immune changes and ecotype distributions, we identified context-dependent associations influenced by both disease biology and treatment effects on the TME. We found that an ecotype enriched for bone marrow-resident populations and limited immune infiltration was associated with tumor expansion and inferior clinical outcomes, whereas ecotypes reflecting T-cell functional states showed distinct associations with immunotherapy response and survival. Our study provides a comprehensive single-cell immune atlas of multiple myeloma and its precursors, offering insights into TME organization and progression, and may guide development of stage-specific or ecotype-targeted immunotherapies.

Article Details

Journal Blood
Volume / Issue Vol. 1, Issue 1
Published July 07, 2026
ISSN 0006-4971
Publisher Elsevier BV

Journal Info

Blood

Elsevier BV

ISSN: 0006-4971 Health Sciences

Authors (30)

M

Minghao Dang

L

Luz Yurany Moreno Rueda

The University of Texas MD Anderson Cancer Center, Houston, Texas, United States

M

Maria Jose Acevedo Calado

The University of Texas MD Anderson Cancer Center, Houston, Texas, United States

H

Hima Bansal

The University of Texas MD Anderson Cancer Center, Houston, Texas, United States

D

David Alejandro Berrios Nolasco

The University of Texas MD Anderson Cancer Center, Houston, Texas, United States

A

Amishi U Vora

The University of Texas MD Anderson Cancer Center, Houston, Texas, United States

J

Jonathan D Mejia

The University of Texas MD Anderson Cancer Center, Houston, Texas, United States

M

Mei Huang

W

Wei Tan

L

Li Qin

Y

Yunhe Liu

Y

Yang Liu

D

David E. Mery

University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States

Y

Yan Cheng

Key Laboratory of Polar Materials and Devices (MOE), School of Information and Electronic Engineering (School of Integrated Circuits Science and Engineering), East China Normal University, Shanghai, China.

 Fenghuang  Zhan

University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States

J

John D. Shaughnessy

University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States

Q

Qing Yi

P

Pei Lin

M

Mahmoud R. Gaballa

The University of Texas MD Anderson Cancer Center, Houston, Texas, United States

O

Oren Pasvolsky

The University of Texas MD Anderson Cancer Center, Houston, Texas, United States

H

Hans C. Lee

1Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX

S

Sheeba K. Thomas

M.D. Anderson Cancer Center, Houston, Texas, United States

D

Donna M Weber

University of Texas, Houston, Texas, United States

K

Krina K. Patel

The University of Texas, MD Anderson Cancer Center, Houston, Texas, United States

M

Melody R Becnel

MD Anderson Cancer Center, houston, Texas, United States

J

Jing Christine Ye

M.D. Anderson Cancer Center, University of Texas, Houston

I

Isere Kuiatse

The University of Texas M. D. Anderson Cancer Center

E

Elisabet E Manasanch

Regeneron Pharmaceuticals, Warren, New Jersey, United States

L

Linghua Wang

R

Robert Z. Orlowski

The University of Texas MD Anderson Cancer Center, Houston, Texas, United States