[Molecular pathogenesis and management of myeloma bone disease].

Hirokazu Miki
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Abstract

The advent of novel anti-multiple myeloma (MM) agents has led to dramatic improvement in patient survival. Nevertheless, the majority of patients with MM have bone lesions, and destructive bone lesions significantly reduce quality of life. Progressive destructive bone lesions develop when osteoblast differentiation from bone marrow stromal cells is inhibited and osteoclasts are activated in the bone marrow microenvironment in patients with MM. Recent research has also shed light on the functions and roles of osteocytes, which account for the majority of bone cells. Since MM cells mainly invade the red marrow, bone lesions are often found in the skull, spine, and ilium, which contain red marrow. Imaging is essential for the diagnosis of MM bone lesions, and whole-body low-dose CT, whole-body MRI, and FDG-PET/CT have demonstrated utility. Furthermore, recent advances in anti-MM drugs have improved the prognosis of MM significantly, highlighting the importance of treating and managing MM bone lesions. This review will explain the molecular pathology and management of MM bone lesions.

骨髓瘤骨病的分子发病机制和治疗
新型抗多发性骨髓瘤(MM)药物的出现显著提高了患者的生存率。然而,大多数MM患者有骨病变,破坏性骨病变显著降低生活质量。当骨髓基质细胞的成骨细胞分化被抑制,破骨细胞在骨髓微环境中被激活时,MM患者会发生进行性破坏性骨病变。最近的研究也揭示了骨细胞的功能和作用,骨细胞占骨细胞的大多数。由于MM细胞主要侵袭红骨髓,故常在含有红骨髓的颅骨、脊柱和髂骨处发现骨病变。影像学对于MM骨病变的诊断是必不可少的,全身低剂量CT、全身MRI和FDG-PET/CT已经证明了其实用性。此外,最近抗MM药物的进展显著改善了MM的预后,突出了治疗和管理MM骨病变的重要性。本文将对MM骨病变的分子病理及治疗作一综述。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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