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First Published Online March 13, 2009
The Oncologist, Vol. 14, No. 3, 276-283, March 2009; doi:10.1634/theoncologist.2009-0003
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Myelomas

Myeloma Bone Disease: Recent Advances in Biology, Diagnosis, and Treatment

Orhan Sezer

Department of Hematology and Oncology, Charité – Universitätsmedizin Berlin, Berlin, Germany

Key Words. Multiple myeloma • Bone • Biochemical markers • Osteoclast • Osteoblast • RANKL • Osteoprotegerin • MIP-1 • DKK-1 • ICTP

Correspondence: Orhan Sezer, M.D., Ph.D., Department of Hematology and Oncology, Charité – Universitätsmedizin Berlin, 10117 Berlin, Germany. Telephone: 49-30-450-613105; Fax: 49-30-450-527907; e-mail: sezer{at}charite.de

Received January 7, 2009; accepted for publication February 16, 2009; first published online in THE ONCOLOGIST Express on March 13, 2009.

Disclosures: Orhan Sezer: Honoraria: Amgen, Novartis, Ortho-Biotech; Research funding/contracted research: Janssen-Cilag, Novartis.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the independent peer reviewers.

Bone disease is a hallmark of multiple myeloma (MM). Occurring in the majority of MM patients, it is associated with bone pain, fractures, and hypercalcemia and has major impacts on quality of life. Furthermore, bone resorption activity has been shown to be an independent risk factor for overall survival in patients with symptomatic MM. Myeloma is characterized by a unique form of bone disease with lytic bone destruction that is not followed by reactive bone formation (uncoupling). This review focuses on recent advances in our understanding of the biology of osteoclast activation and osteoblast inhibition in MM, diagnostic standards, and recent progress in treatment options for myeloma bone disease. Translational research has enabled a rapid transfer of mechanistic insights from the bench to the bedside and will hopefully result in better treatment options and outcome for patients in near future.


Related articles in The Oncologist:

Bone-Resorbing Cells in Multiple Myeloma: Osteoclasts, Myeloma Cell Polykaryons, or Both?
Franco Silvestris, Sabino Ciavarella, Monica De Matteo, Marco Tucci, and Franco Dammacco
The Oncologist 2009 14: 264-275. [Abstract] [Full Text]  





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