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Multiple Myeloma and Other Plasma Cell Neoplasms pp 111–140Cite as

Bone Disease

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Part of the book series: Hematologic Malignancies ((HEMATOLOGIC))

Abstract

Bone disease is one of the most common complications of multiple myeloma. It is the result of increased osteoclast activity which is not compensated by osteoblast activity and leads to osteolytic lesions characterized by bone pain and increased risk for pathological fracture, spinal cord compression and need for radiotherapy or surgery to the bone. Imaging techniques for the diagnosis of multiple myeloma bone disease include whole-body X-rays, whole-body low-dose CT (WBLDCT), magnetic resonance imaging (MRI), and PET/CT. Bisphosphonates (BPs) are the cornerstone in the treatment of myeloma-related bone disease. Recent studies have revealed novel pathways and molecules that are involved in the biology of myeloma bone disease including the receptor activator of nuclear factor-kappa B ligand/osteoprotegerin pathway, the Wnt signaling inhibitors dickkopf-1 and sclerostin, macrophage inflammatory proteins, activin A, and others. The thorough study of these pathways has provided novel agents that may play a critical role in the management of myeloma-related bone disease in the near future, such as denosumab (anti-RANKL), sotatercept (activin A antagonist), romosozumab (anti-sclerostin), or BHQ-880 (anti-dickkopf-1). In this chapter, we will focus in the imaging techniques used for the diagnosis of multiple myeloma bone disease, as well as the current and future options for its management.

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Authors and Affiliations

  1. Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

    Evangelos Terpos & Nikolaos Kanellias

  2. Center for Multiple Myeloma, Massachusetts General Hospital Cancer Center, Boston, MA, USA

    Noopur Raje

Authors
  1. Evangelos Terpos
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  2. Nikolaos Kanellias
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  3. Noopur Raje
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Correspondence to Evangelos Terpos .

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Editors and Affiliations

  1. School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

    Meletios A. Dimopoulos

  2. Service des Maladies du Sang, CHRU Lille Hôpital Claude Huriez, Lille, France

    Thierry Facon

  3. School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

    Evangelos Terpos

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Terpos, E., Kanellias, N., Raje, N. (2018). Bone Disease. In: Dimopoulos, M., Facon, T., Terpos, E. (eds) Multiple Myeloma and Other Plasma Cell Neoplasms. Hematologic Malignancies. Springer, Cham. https://doi.org/10.1007/978-3-319-25586-6_7

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  • DOI: https://doi.org/10.1007/978-3-319-25586-6_7

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