Bone disease in multiple myeloma

Homare Eda, Loredana Santo, G. David Roodman, Noopur Raje

Research output: Chapter in Book/Report/Conference proceedingChapter

12 Scopus citations


Bone involvement represented by osteolytic bone disease (OBD) or osteopenia is one of the pathognomonic and defining characteristics of multiple myeloma (MM). Nearly 90 % of patients with MM develop osteolytic bone lesions, frequently complicated by skeletal-related events (SRE) such as severe bone pain, pathological fractures, vertebral collapse, hypercalcemia, and spinal cord compression. All of these not only result in a negative impact on quality of life but also adversely impact overall survival. OBD is a consequence of increased osteoclast (OC) activation along with osteoblast (OB) inhibition, resulting in altered bone remodeling. OC number and activity are increased in MM via cytokine deregulation within the bone marrow (BM) milieu, whereas negative regulators of OB differentiation suppress bone formation. Inhibition of osteolysis and stimulation of OB differentiation leads to reduced tumor growth in vivo. Therefore, novel agents targeting OBD are promising therapeutic strategies not only for the treatment of MM OBD but also for the treatment of MM. Several novel agents in addition to bisphosphonates are currently under investigation for their positive effect on bone remodeling via OC inhibition or OB stimulation. Future studies will look to combine or sequence all of these agents with the goal of not only alleviating morbidity from MM OBD but also capitalizing on the resultant antitumor activity.

Original languageEnglish (US)
Title of host publicationCancer Treatment and Research
PublisherKluwer Academic Publishers
Number of pages20
StatePublished - Jan 1 2016
Externally publishedYes

Publication series

NameCancer Treatment and Research
ISSN (Print)0927-3042


  • Bone disease
  • Multiple myeloma
  • Therapies

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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  • Cite this

    Eda, H., Santo, L., Roodman, G. D., & Raje, N. (2016). Bone disease in multiple myeloma. In Cancer Treatment and Research (pp. 251-270). (Cancer Treatment and Research; Vol. 169). Kluwer Academic Publishers.