Myeloma Bone Disease

Myeloma means, literally, a "tumor composed of cells normally found in bone marrow." The majority of patients with myeloma develop destructive bone lesions, also known as osteolytic bone lesions. These lesions occur primarily in the vertebrae, the ribs, the pelvis, and the skull. They occur in the red bone marrow where nests of myeloma cells accumulate. Myeloma cells do not have a direct effect on the skeleton; rather, they cause bone destruction by producing signals that activate normal osteoclasts to resorb bone. Why this occurs is not clearly understood. There is currently, however, a large amount of research directed at understanding the mechanisms by which bone is destroyed by myeloma cells.
The skeletal lesions that occur in myeloma not only result in pain, pathological fractures, and hypercalcemia, but sometimes deformity and occasionally nerve compression syndromes. The lesions occur most commonly in the vertebrae. The appearance of the vertebral spine may resemble osteoporosis radiologically although the histologic abnormalities are quite different.
Clinical Symptoms
Approximately 70% of myeloma patients experience pain of varying intensity, often in the lower back. Sudden severe pain can be a sign of fracture or collapse of a vertebra. Patients also have general malaise and vague complaints. Hypercalcemia (too much calcium in the blood), which is present in 30% of patients, can cause tiredness, thirst, and nausea, and usually occurs when a patient has impaired kidney function.
Content Courtesy : www.osteo.org
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