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The pathogenesis of the bone disease of multiple myeloma
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Abstract
Multiple myeloma is a fatal hematologic malignancy associated with clonal expansion
of malignant plasma cells within the bone marrow and the development of a destructive
osteolytic bone disease. The principal cellular mechanisms involved in the development
of myeloma bone disease are an increase in osteoclastic bone resorption, and a reduction
in bone formation. Myeloma cells are found in close association with sites of active
bone resorption, and the interactions between myeloma cells and other cells within
the specialized bone marrow microenvironment are essential, both for tumor growth
and the development of myeloma bone disease. This review discusses the many different
factors which have been implicated in myeloma bone disease, including the evidence
for their role in myeloma and subsequent therapeutic implications.