Treatment of multiple myeloma-related bone disease: recommendations from the Bone Working Group of the International Myeloma Working Group
Por:
Terpos E, Zamagni E, Lentzsch S, Drake MT, 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 MA, Munshi N, Durie BGM, Raje N and Bone Working Group of the International Myeloma Working Group
Publicada:
1 mar 2021
Ahead of Print:
1 mar 2021
Categoría:
Oncology
Resumen:
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.
Filiaciones:
Terpos E:
Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Zamagni E:
Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, S Orsola Malpighi Hospital, Bologna, Italy
Lentzsch S:
Division of Hematology and Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA
Drake MT:
Division of Endocrinology, Diabetes, Metabolism, and Nutrition and Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
García-Sanz R:
Department of Hematology, University Hospital of Salamanca, Salamanca, Spain
Abildgaard N:
Hematology Research Unit, Department of Clinical Research, and Department of Hematology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
Ntanasis-Stathopoulos I:
Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Schjesvold F:
Oslo Myeloma Center, Oslo University Hospital, and KG Jebsen Center for B Cell Malignancies, University of Oslo, Oslo, Norway
:
Department of Hematology, University Hospital Doctor Peset, School of Medicine and Dentistry, Catholic University of Valencia, Valencia, Spain
Kyriakou C:
University College London Hospital NHS Foundation Trust, London, UK
Hillengass J:
Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
Zweegman S:
Department of Hematology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, Netherlands
Cavo M:
Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, S Orsola Malpighi Hospital, Bologna, Italy
Moreau P:
Department of Hematology, University Hospital Hotel-Dieu, Nantes, France
San-Miguel J:
Center for Applied Medical Research, Clínica Universidad de Navarra, University of Navarra, and Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
Dimopoulos MA:
Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Munshi N:
Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
Durie BGM:
Department of Hematology and Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Raje N:
Center for Multiple Myeloma, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
Green Submitted, Green Accepted
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