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Myeloma Bone Disease pp 63–89Cite as

Biochemical Markers of Bone Remodeling in Multiple Myeloma

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Part of the book series: Current Clinical Oncology ((CCO))

Abstract

Osteolytic bone disease is a frequent complication of multiple myeloma which results in significant skeletal morbidity. A characteristic feature of myeloma bone disease is that the lesions rarely heal and bone scans are often negative in myeloma patients who have extensive lytic lesions, offering very little in the follow-up of bone disease. X-rays are also of limited value in monitoring bone destruction during anti-myeloma or anti-resorptive treatment. Biochemical markers of bone resorption, such as N- and C-terminal cross-linking telopeptide of type I collagen and markers of bone formation, such as bone-specific alkaline phosphatase and osteocalcin, provide information on bone dynamics that in turn may reflect disease activity in bone. These markers have been investigated as tools for evaluating the extent of bone disease, risk of skeletal morbidity, and response to anti-resorptive treatment in myeloma. Several studies have shown that the majority of biochemical markers of bone resorption are elevated in myeloma patients with lytic bone lesions, thus reflecting changes in bone metabolism associated with tumor growth. There is also a growing body of evidence that markers of bone resorption correlate with the risk of skeletal complications, disease progression, and survival. In addition, bone markers could potentially be used as a tool for early diagnosis of bone lesions. This chapter summarizes the existing data for the role of bone markers in assessing the extent of bone destruction in myeloma and monitoring bone turnover during specific anti-myeloma therapies, while it gives information for novel markers that may be of particular interest in the near future.

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  1. Department of Clinical Therapeutics, University of Athens School of Medicine, Alexandra Hospital, 80 Vas. Sofias Av, Athens, 115-28, Greece

    Evangelos Terpos

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  1. Dept. Medicine, University of Pittsburgh, Centre Avenue 5115, Pittsburgh, 15232, USA

    G. David Roodman

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Terpos, E. (2010). Biochemical Markers of Bone Remodeling in Multiple Myeloma. In: Roodman, G. (eds) Myeloma Bone Disease. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-60761-554-5_3

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