Multiple Myeloma Associated Bone Disease
1
Department of Haematology, Odense University Hospital, Kloevervaenget 10, 12th Floor, DK-5000 Odense, Denmark
2
Department of Internal Medicine, Division of Haematology, Sydvestjysk Sygehus, Finsensgade 35, DK-6700 Esbjerg, Denmark
3
Haematology Research Unit, Department of Clinical Research, University of Southern Denmark, Kloevervaenget 10, 12th Floor, DK-5000 Odense, Denmark
4
Department of Clinical Radiology, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense, Denmark
5
Department of Nuclear Medicine, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense, Denmark
6
Center for Spine Surgery & Research, Lillebaelt Hospital, Østre Hougvel 55, DK-5500 Middelfart, Denmark
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(8), 2113; https://doi.org/10.3390/cancers12082113
Received: 2 July 2020
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Revised: 27 July 2020
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Accepted: 27 July 2020
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Published: 30 July 2020
(This article belongs to the Special Issue Recent Advances on the Pathobiology and Treatment of Multiple Myeloma)
The lytic bone disease is a hallmark of multiple myeloma, being present in about 80% of patients with newly diagnosed MM, and in more during the disease course. The myeloma associated bone disease (MBD) severely affects the morbidity and quality of life of the patients. MBD defines treatment demanding MM. In recent years, knowledge of the underlying pathophysiology has increased, and novel imaging technologies, medical and non-pharmaceutical treatments have improved. In this review, we highlight the major achievements in understanding, diagnosing and treating MBD. For diagnosing MBD, low-dose whole-body CT is now recommended over conventional skeletal survey, but also more advanced functional imaging modalities, such as diffusion-weighted MRI and PET/CT are increasingly important in the assessment and monitoring of MBD. Bisphosphonates have, for many years, played a key role in management of MBD, but denosumab is now an alternative to bisphosphonates, especially in patients with renal impairment. Radiotherapy is used for uncontrolled pain, for impeding fractures and in treatment of impeding or symptomatic spinal cord compression. Cement augmentation has been shown to reduce pain from vertebral compression fractures. Cautious exercise programs are safe and feasible and may have the potential to improve the status of patients with MM.
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Keywords:
multiple myeloma; myeloma bone disease; pathophysiology; osteolysis; imaging; zoledronic acid; denosumab; vertebral augmentation; rehabilitation; exercise
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MDPI and ACS Style
Rasch, S.; Lund, T.; Asmussen, J.T.; Lerberg Nielsen, A.; Faebo Larsen, R.; Østerheden Andersen, M.; Abildgaard, N. Multiple Myeloma Associated Bone Disease. Cancers 2020, 12, 2113. https://doi.org/10.3390/cancers12082113
AMA Style
Rasch S, Lund T, Asmussen JT, Lerberg Nielsen A, Faebo Larsen R, Østerheden Andersen M, Abildgaard N. Multiple Myeloma Associated Bone Disease. Cancers. 2020; 12(8):2113. https://doi.org/10.3390/cancers12082113
Chicago/Turabian StyleRasch, Stine, Thomas Lund, Jon T. Asmussen, Anne Lerberg Nielsen, Rikke Faebo Larsen, Mikkel Østerheden Andersen, and Niels Abildgaard. 2020. "Multiple Myeloma Associated Bone Disease" Cancers 12, no. 8: 2113. https://doi.org/10.3390/cancers12082113
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