title: Bone disease in multiple myeloma and precursor disease: novel diagnostic approaches and implications on clinical management.
abstract: The manifestations of bone involvement in patients with multiple myeloma (MM) can have devastating clinical effects and increase mortality. Recent studies demonstrate that patients with the precursor conditions smoldering MM (SMM) and monoclonal gammopathy of undetermined significance (MGUS) show evidence of bone disease and increased risk of fractures. The understanding of the pathogenesis of bone disease in MM has expanded in recent years. The traditional skeletal survey will probably be replaced by newer and more sensitive imaging techniques, which may have a prognostic impact and change our definition of MGUS and SMM. Bisphosphonates are recommended to prevent skeletal events in patients with MM, and have also been studied in SMM and MGUS. This article summarizes the current knowledge of bone disease in plasma cell disorders, and discusses the current standard and future role of novel imaging techniques, as well as the evidence and current guidelines for bisphosphonates in MM, SMM and MGUS.
authors: Department of Medicine, Division of Hematology, Karolinska University Hospital Solna, SE-171 76, Stockholm, Sweden. sigurdur.kristinsson@karolinska.se
authors: Sigurdur Y
authors: SY
authors: Kristinsson
authors: Alex R
authors: AR
authors: Minter
authors: Neha
authors: N
authors: Korde
authors: Esther
authors: E
authors: Tan
authors: Ola
authors: O
authors: Landgren
mesh_terms: D001847:Bone Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000473:pathology; D004164:Diphosphonates / Q000627:therapeutic use; D006801:Humans; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000150:complications / Q000473:pathology; D009101:Multiple Myeloma / Q000150:complications* / Q000473:pathology; D011859:Radiography; D011877:Radionuclide Imaging; D016032:Randomized Controlled Trials as Topic
chemical_list: D004164:Diphosphonates