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Blood Cancer J. 2019 Feb 26;9(3):27. doi: 10.1038/s41408-019-0187-7.

The role of cement augmentation with percutaneous vertebroplasty and balloon kyphoplasty for the treatment of vertebral compression fractures in multiple myeloma: a consensus statement from the International Myeloma Working Group (IMWG).

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University College London and Northwick Park Hospitals, London, UK.
Royal National Orthopedic Hospital, Stanmore, UK.
Royal National Orthopedic Hospital, Stanmore, UK.
Moffitt Cancer Center, University of South Florida, Tampa, FL, USA.
Roswell Park Cancer Center, Buffalo, NY, USA.
Klinikum Leverkusen, Leverkusen, Germany.
Karmanos Cancer Institute, Detroit, MI, USA.
Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Massachusetts General Hospital, Boston, MA, USA.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Indiana University, Indianapolis, IN, USA.
University of Athens School of Medicine, Athens, Greece.
Mayo Clinic, Rochester, MN, USA.
Cedars-Sinai Samuel Oschin Cancer Center, Los Angeles, CA, USA.


Multiple myeloma (MM) represents approximately 15% of haematological malignancies and most of the patients present with bone involvement. Focal or diffuse spinal osteolysis may result in significant morbidity by causing painful progressive vertebral compression fractures (VCFs) and deformities. Advances in the systemic treatment of myeloma have achieved high response rates and prolonged the survival significantly. Early diagnosis and management of skeletal events contribute to improving the prognosis and quality of life of MM patients. The management of patients with significant pain due to VCFs in the acute phase is not standardised. While some patients are successfully treated conservatively, and pain relief is achieved within a few weeks, a large percentage has disabling pain and morbidity and hence they are considered for surgical intervention. Balloon kyphoplasty and percutaneous vertebroplasty are minimally invasive procedures which have been shown to relieve pain and restore function. Despite increasing positive evidence for the use of these procedures, the indications, timing, efficacy, safety and their role in the treatment algorithm of myeloma spinal disease are yet to be elucidated. This paper reports an update of the consensus statement from the International Myeloma Working Group on the role of cement augmentation in myeloma patients with VCFs.

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