title: Bone disease in multiple myeloma: pathophysiology and management.
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.
authors.affiliation: Medical Oncology Department, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. ; Mater Misericordaie University Hospital, Dublin, Ireland. ; Dublin City University, Dublin, Ireland.
authors.forename: Abdul
authors.initials: A
authors.lastname: Hameed
authors.affiliation: Department of Biochemistry, Mater Misericordaie University Hospital, Dublin, Ireland.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Brady
authors.affiliation: National Institute for cellular Biotechnology, Dublin City University, Dublin, Ireland.
authors.forename: Paul
authors.initials: P
authors.lastname: Dowling
authors.affiliation: National Institute for cellular Biotechnology, Dublin City University, Dublin, Ireland.
authors.forename: Martin
authors.initials: M
authors.lastname: Clynes
authors.affiliation: National Institute for cellular Biotechnology, Dublin City University, Dublin, Ireland. ; Hematology Department, Mater Misericordaie University Hospital, Dublin, Ireland.
authors.forename: Peter
authors.initials: P
authors.lastname: O'Gorman
keywords: bisphosphonates; cytokines; osteoblastogenesis; osteoblasts; osteoclastogenesis; osteoclasts