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Operative Therapie bei Patienten mit multiplem Myelom

Surgical treatment in patients with multiple myeloma of the bone

  • Myelom
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Bei mehr als 50% aller Patienten mit multiplem Myelom kommt es während des Krankheitsverlaufs zur pathologischen Fraktur. Mit 15% ist das multiple Myelom zudem der häufigste Tumor der Wirbelsäule, 8–10% der Patienten entwickeln neurologische Ausfälle bis hin zur Paraplegie. Entsprechend ist die operative Therapie des multiplen Myeloms eine im individuellen Krankheitsverlauf absolut relevante Maßnahme, wenngleich naturgemäß eine tatsächliche prognostische Beeinflussung der Erkrankung nur in den sehr seltenen Fällen des peripheren solitären Plasmozytoms stattfinden kann.

Abstract

More than 50% of all patients with multiple myeloma will sustain a pathological fracture during the course of their disease. Accounting for 15% of all malignant lesions of the spine, multiple myeloma is the most common spinal tumor: 8–10% of the patients develop neurological impairment which in some cases even leads to paraplegia. Hence, surgery in patients with multiple myeloma lesions is a very important therapeutic approach in the individual course of the disease. One has to be aware however that surgery generally will not influence the prognosis in those patients with the rare exception of resections in solitary peripheral lesions of the extremity.

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Literatur

  1. Bataille R, Sany J (1981) Solitary myeloma: clinical and prognostic features of a review of 114 cases. Cancer 48:845–851

    CAS  PubMed  Google Scholar 

  2. Baur A (2000) Diagnostik des Plasmozytoms mit der MRT. Radiologe 40:716–722

    Article  CAS  PubMed  Google Scholar 

  3. Brinch L, Hannisdal E, Abrahamsen AF, Kvaloy S, Langholm R (1990) Extramedullary plasmacytomas and solitary plasma cell tumours of bone. Eur J Haematol 44:132–135

    CAS  PubMed  Google Scholar 

  4. Damron TA, Sim FH, Shives TC, An KN, Rock MG, Pritchard DJ (1996) Intercalary spacers in the treatment of segmentally destructive diaphyseal humeral lesions in disseminated malignancies. Clin Orthop 324:233–243

    Article  PubMed  Google Scholar 

  5. Diamond TH, Hartwell T, Clarke W, Manoharan A (2004) Percutaneous vertebroplasty for acute vertebral body fracture and deformity in multiple myeloma: a short report. Br J Haematol 124:485–487

    PubMed  Google Scholar 

  6. Dürr HR, Kühne JH, Hagena FW, Moser T, Refior HJ (1997) Surgical treatment for myeloma of the bone. A retrospective analysis of 22 cases. Arch Orthop Trauma Surg 116:463–469

    Article  PubMed  Google Scholar 

  7. Dürr HR, Rechl H (2002) Operative Therapie. In: Bartl R, Dietzfelbinger H (Hrsg) Manual des Tumorzentrums München, Empfehlungen zur Diagnostik, Therapie und Nachsorge. Zuckschwerdt, München, S 143–145

  8. Dürr HR, Wegener B, Krödel A, Müller PE, Jansson V, Refior HJ (2002) Multiple myeloma: surgery of the spine: retrospective analysis of 27 patients. Spine 27:320–324

    Article  PubMed  Google Scholar 

  9. Frassica DA, Frassica FJ, Schray MF, Sim FH, Kyle RA (1989) Solitary plasmacytoma of bone: Mayo Clinic experience. Int J Radiat Oncol Biol Phys 16:43–48

    CAS  PubMed  Google Scholar 

  10. Ganjoo RK, Malpas JS, Plowman PN (1993) Solitary plasmacytoma of bone-a rare disorder with an unusual evolution. Postgrad Med J 69:153–154

    CAS  PubMed  Google Scholar 

  11. Harrington KD, Johnston JO, Turner RH, Green DL (1972) The use of methylmethacrylate as an adjunct in the internal fixation of malignant neoplastic fractures. J Bone Joint Surg Am 54:1665–1676

    CAS  PubMed  Google Scholar 

  12. Helmberger T, Bohndorf K, Hierholzer J, Noldge G, Vorwerk D (2003) [Guidelines of the German Radiological Society for percutaneous vertebroplasty]. Radiologe 43:703–708

    Article  CAS  PubMed  Google Scholar 

  13. Hipp JA, Springfield DS, Hayes WC (1995) Predicting pathologic fracture risk in the management of metastatic bone defects. Clin Orthop 312:120–135

    PubMed  Google Scholar 

  14. Jonsson B, Sjostrom L, Jonsson H, Jr., Karlstrom G (1992) Surgery for multiple myeloma of the spine. A retrospective analysis of 12 patients. Acta Orthop Scand 63:192–194

    CAS  PubMed  Google Scholar 

  15. Kivioja AH, Karaharju EO, Elomaa I, Bohling TO (1992) Surgical treatment of myeloma of bone. Eur J Cancer 28A: 1865–1869

    Article  CAS  PubMed  Google Scholar 

  16. Knahr K, Salzer M (1974) Die Endoprothesenversorgung von Metastasen und primär malignen Knochentumoren des proximalen Femurendes. Z Orthop Ihre Grenzgeb 112:1044–1052

    CAS  PubMed  Google Scholar 

  17. Kochbati L, Ben Romdhane NK, Mrad K, Nasr C, Ben Salah DE, Ben Romdhane K, Maalej M (2004) Solitary bone plasmocytoma: treatment and outcome features. Cancer Radiother 8:70–74

    Article  CAS  PubMed  Google Scholar 

  18. Krikler SJ (1997) Multiple myeloma. Surgery is often more effective than analgesia for mechanical pain. BMJ 315:186

    CAS  Google Scholar 

  19. Kyle RA (1975) Multiple myeloma: review of 869 cases. Mayo Clin Proc 50:29–40

    CAS  PubMed  Google Scholar 

  20. McLain RF, Weinstein JN (1989) Solitary plasmacytomas of the spine: a review of 84 cases. J Spinal Disord 2:69–74

    CAS  PubMed  Google Scholar 

  21. Olerud C, Jonsson B (1996) Surgical palliation of symptomatic spinal metastases. Acta Orthop Scand 67:513–522

    CAS  PubMed  Google Scholar 

  22. Perrin RG, McBroom RJ (1987) Anterior versus posterior decompression for symptomatic spinal metastasis. Can J Neurol Sci 14:75–80

    CAS  PubMed  Google Scholar 

  23. Vandeweyer E, Gebhart M (1997) Treatment of humeral pathological fractures by internal fixation and methylmetacrylate injection. Eur J Surg Oncol 23:238–242

    CAS  PubMed  Google Scholar 

  24. Wedin R (2001) Surgical treatment for pathologic fracture. Acta Orthop Scand Suppl 72:2p-29

    PubMed  Google Scholar 

  25. Weinstein JN, McLain RF (1987) Primary tumors of the spine. Spine 12:843–851

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Orthopädische Klinik und Poliklinik, Klinikum Großhadern, Ludwig-Maximilians-Universität München

    H. R. Dürr & V. Jansson

  2. Medizinische Klinik III, Klinikum Großhadern, Ludwig-Maximilians-Universität München

    M. Schlemmer

  3. Institut für Radiologie, Klinikum Großhadern, Ludwig-Maximilians-Universität München

    A. Baur

  4. Schwerpunkt Tumororthopädie, Orthopädische Klinik und Poliklinik, Klinikum Großhadern, Ludwig-Maximilians-Universität, Marchionistraße 15, 81377 , München

    H. R. Dürr

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  1. H. R. Dürr
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  2. M. Schlemmer
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  3. A. Baur
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  4. V. Jansson
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Correspondence to H. R. Dürr.

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Dürr, H.R., Schlemmer, M., Baur, A. et al. Operative Therapie bei Patienten mit multiplem Myelom. Onkologe 10, 852–857 (2004). https://doi.org/10.1007/s00761-004-0742-z

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  • DOI: https://doi.org/10.1007/s00761-004-0742-z

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