Τίτλος:
Treatment of multiple myeloma-related bone disease: recommendations from the Bone Working Group of the International Myeloma Working Group
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
In this Policy Review, the Bone Working Group of the International Myeloma Working Group updates its clinical practice recommendations for the management of multiple myeloma-related bone disease. After assessing the available literature and grading recommendations using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) method, experts from the working group recommend zoledronic acid as the preferred bone-targeted agent for patients with newly diagnosed multiple myeloma, with or without multiple myeloma-related bone disease. Once patients achieve a very good partial response or better, after receiving monthly zoledronic acid for at least 12 months, the treating physician can consider decreasing the frequency of or discontinuing zoledronic acid treatment. Denosumab can also be considered for the treatment of multiple myeloma-related bone disease, particularly in patients with renal impairment. Denosumab might prolong progression-free survival in patients with newly diagnosed multiple myeloma who have multiple myeloma-related bone disease and who are eligible for autologous stem-cell transplantation. Denosumab discontinuation is challenging due to the rebound effect. The Bone Working Group of the International Myeloma Working Group also found cement augmentation to be effective for painful vertebral compression fractures. Radiotherapy is recommended for uncontrolled pain, impeding or symptomatic spinal cord compression, or pathological fractures. Surgery should be used for the prevention and restoration of long-bone pathological fractures, vertebral column instability, and spinal cord compression with bone fragments within the spinal route. © 2021 Elsevier Ltd
Συγγραφείς:
Terpos, E.
Zamagni, E.
Lentzsch, S.
Drake, M.T.
García-Sanz, R.
Abildgaard, N.
Ntanasis-Stathopoulos, I.
Schjesvold, F.
de la Rubia, J.
Kyriakou, C.
Hillengass, J.
Zweegman, S.
Cavo, M.
Moreau, P.
San-Miguel, J.
Dimopoulos, M.A.
Munshi, N.
Durie, B.G.M.
Raje, N.
Bone Working Group of the International Myeloma Working Group
Περιοδικό:
The lancet oncology
Εκδότης:
The Lancet Publishing Group
Λέξεις-κλειδιά:
amoxicillin plus clavulanic acid; calcium; clodronic acid; denosumab; pamidronic acid; vitamin D; zoledronic acid; bone density conservation agent, antibiotic prophylaxis; autologous stem cell transplantation; bone disease; bone metabolism; cancer radiotherapy; cancer recurrence; cancer surgery; cause of death; compression fracture; computer assisted tomography; consensus; coronavirus disease 2019; decision making; decompression surgery; disease association; human; hypercalcemia; jaw osteonecrosis; kyphoplasty; multiple myeloma; nuclear magnetic resonance imaging; osteolysis; osteoporosis; overall survival; pathologic fracture; percutaneous vertebroplasty; postoperative period; practice guideline; progression free survival; prospective study; radiation dose; Review; risk reduction; spinal cord compression; treatment duration; vitamin supplementation; bone disease; complication; multiple myeloma; pathology; practice guideline, Bone Density Conservation Agents; Bone Diseases; Humans; Multiple Myeloma; Practice Guidelines as Topic
DOI:
10.1016/S1470-2045(20)30559-3