HPSE and plasma cell myeloma: Heparanase enhances shedding of syndecan-1 and high levels of heparanase and shed syndecan-1 in the tumor microenvironment are associated with elevated angiogenesis and poor prognosis in myeloma, by activating integrin and VEGF receptors on adjacent endothelial cells thereby stimulating tumor angiogenesis (80, 81).