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While the reaction of the therapeutic antibody seems relatively straightforward on the myeloma side (as MM cells are FcR-negative), more complex interactions occur with effector cells (FcR + ), where the antibody can engage both the Fab-binding site and one of the FcRs on the same cell ( Figure 3 ) (110)

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Furthermore, IGFBPs other than IGFBP-3 may play a role in the access of IGF-I to various tissues (129)