Therapy of Myeloma Bone Disease

Abstract

Bone disease is a cardinal complication of multiple myeloma that affects quality of life and survival. Osteocytes have emerged as key players in the development of myeloma-related bone disease. Along with other factors, they participate in increased osteoclast activity, decreased osteoblast function, and immunosuppressed marrow microenvironment that deregulate bone turnover and result in bone loss and skeletal-related events. Bisphosphonates are the mainstay in the treatment of myeloma bone disease. Denosumab is a novel alternative to bisphosphonates, especially for patients with renal impairment. A deeper understanding of the physiopathology of bone disease will enable the transition of more novel agents from the bench to the bedside.