Pathophysiology of Bone Disease in Multiple Myeloma

  • Tomer M. Mark
  • Roger N. Pearse
Part of the Contemporary Hematology book series (CH)


Multiple myeloma (MM) is a malignancy of plasma cells characterized by growth in the bone marrow (BM) environment and the development of lytic lesions in the skeleton. These lytic lesions are responsible for many of the clinical sequelae of progressive disease, including pathologic fractures, severe pain, and hypercalcemia.1 Historically, the burden of skeletal disease has been used to predict MM prognosis and survival, as outlined in the Salmon-Durie staging system.2 However, this correlation is weakened by the finding of increased prevalence of bone disease in MM with favorable cytogenetics.3 As a result, bone disease has been omitted from recent staging schema.4 Nonetheless, bone destruction remains a major source of morbidity.5

The hallmark of MM bone disease is the development of osteolytic lesions without associated osteoblastic activity. The absence of reactive bone formation renders MM-associated skeletal lesions silent on bone scan, and helps to explain the...


Multiple Myeloma Bone Marrow Stromal Cell Bone Destruction Adenomatous Polyposis Coli Gene Bone Marrow Plasma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Tomer M. Mark
    • 1
  • Roger N. Pearse
    • 1
  1. 1.Weil Medical College of Cornell UniveristyNew YorkUSA

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