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Is the bone marrow microenvironment the hidden catalyst in malignant haematopoiesis?

Over the past decades, a recurring question in haematologic research has been the role of the bone marrow niche in myeloid malignancies such as Myelodysplastic Syndromes (MDS) and Acute Myeloid Leukaemia (AML). This highly controversial debate has centred on whether—and to what extent—the bone marrow microenvironment (BMME) actively drives the transformation of healthy hematopoietic stem cells (HSCs) into malignant counterparts or simply provides a permissive environment where cancer cells thrive (Fig.

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