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Cancer Growth Metastasis. 2014 Aug 10;7:33-42. doi: 10.4137/CGM.S16817. eCollection 2014.

Bone disease in multiple myeloma: pathophysiology and management.

Author information

1
Medical Oncology Department, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. ; Mater Misericordaie University Hospital, Dublin, Ireland. ; Dublin City University, Dublin, Ireland.
2
Department of Biochemistry, Mater Misericordaie University Hospital, Dublin, Ireland.
3
National Institute for cellular Biotechnology, Dublin City University, Dublin, Ireland.
4
National Institute for cellular Biotechnology, Dublin City University, Dublin, Ireland. ; Hematology Department, Mater Misericordaie University Hospital, Dublin, Ireland.

Abstract

Myeloma bone disease (MBD) is a devastating complication of multiple myeloma (MM). More than 80% of MM patients suffer from destructive bony lesions, leading to pain, fractures, mobility issues, and neurological deficits. MBD is not only a main cause of disability and morbidity in MM patients but also increases the cost of management. Bone destruction and lack of bone formation are main factors in the development of MBD. Some novel factors are found to be involved in the pathogenesis of MBD, eg, receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG) system (RANKL/OPG), Wingless (Wnt), dickkopf-1 (Wnt/DKK1) pathway. The addition of novel agents in the treatment of MM, use of bisphosphonates and other supportive modalities such as radiotherapy, vertebroplasty/kyphoplasty, and surgical interventions, all have significant roles in the treatment of MBD. This review provides an overview on the pathophysiology and management of MBD.

KEYWORDS:

bisphosphonates; cytokines; osteoblastogenesis; osteoblasts; osteoclastogenesis; osteoclasts

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