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Bone Disease in Multiple Myeloma: Biologic and Clinical Implications

Multiple Myeloma (MM) is a hematologic malignancy characterized by the proliferation of monoclonal plasma cells localized within the bone marrow. Bone disease with associated osteolytic lesions is a hallmark of MM and develops in the majority of MM patients. Approximately half of patients with bone...

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Autores principales: Bernstein, Zachary S., Kim, E. Bridget, Raje, Noopur
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9367243/
https://www.ncbi.nlm.nih.gov/pubmed/35954151
http://dx.doi.org/10.3390/cells11152308
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author Bernstein, Zachary S.
Kim, E. Bridget
Raje, Noopur
author_facet Bernstein, Zachary S.
Kim, E. Bridget
Raje, Noopur
author_sort Bernstein, Zachary S.
collection PubMed
description Multiple Myeloma (MM) is a hematologic malignancy characterized by the proliferation of monoclonal plasma cells localized within the bone marrow. Bone disease with associated osteolytic lesions is a hallmark of MM and develops in the majority of MM patients. Approximately half of patients with bone disease will experience skeletal-related events (SREs), such as spinal cord compression and pathologic fractures, which increase the risk of mortality by 20–40%. At the cellular level, bone disease results from a tumor-cell-driven imbalance between osteoclast bone resorption and osteoblast bone formation, thereby creating a favorable cellular environment for bone resorption. The use of osteoclast inhibitory therapies with bisphosphonates, such as zoledronic acid and the RANKL inhibitor denosumab, have been shown to delay and lower the risk of SREs, as well as the need for surgery or radiation therapy to treat severe bone complications. This review outlines our current understanding of the molecular underpinnings of bone disease, available therapeutic options, and highlights recent advances in the management of MM-related bone disease.
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spelling pubmed-93672432022-08-12 Bone Disease in Multiple Myeloma: Biologic and Clinical Implications Bernstein, Zachary S. Kim, E. Bridget Raje, Noopur Cells Review Multiple Myeloma (MM) is a hematologic malignancy characterized by the proliferation of monoclonal plasma cells localized within the bone marrow. Bone disease with associated osteolytic lesions is a hallmark of MM and develops in the majority of MM patients. Approximately half of patients with bone disease will experience skeletal-related events (SREs), such as spinal cord compression and pathologic fractures, which increase the risk of mortality by 20–40%. At the cellular level, bone disease results from a tumor-cell-driven imbalance between osteoclast bone resorption and osteoblast bone formation, thereby creating a favorable cellular environment for bone resorption. The use of osteoclast inhibitory therapies with bisphosphonates, such as zoledronic acid and the RANKL inhibitor denosumab, have been shown to delay and lower the risk of SREs, as well as the need for surgery or radiation therapy to treat severe bone complications. This review outlines our current understanding of the molecular underpinnings of bone disease, available therapeutic options, and highlights recent advances in the management of MM-related bone disease. MDPI 2022-07-27 /pmc/articles/PMC9367243/ /pubmed/35954151 http://dx.doi.org/10.3390/cells11152308 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Bernstein, Zachary S.
Kim, E. Bridget
Raje, Noopur
Bone Disease in Multiple Myeloma: Biologic and Clinical Implications
title Bone Disease in Multiple Myeloma: Biologic and Clinical Implications
title_full Bone Disease in Multiple Myeloma: Biologic and Clinical Implications
title_fullStr Bone Disease in Multiple Myeloma: Biologic and Clinical Implications
title_full_unstemmed Bone Disease in Multiple Myeloma: Biologic and Clinical Implications
title_short Bone Disease in Multiple Myeloma: Biologic and Clinical Implications
title_sort bone disease in multiple myeloma: biologic and clinical implications
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9367243/
https://www.ncbi.nlm.nih.gov/pubmed/35954151
http://dx.doi.org/10.3390/cells11152308
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