Sakalová A, Herrmann Z, Gazová S, Chabronová I, Dedík L, Mistrík M, Hrubisko M
Klinika hematológie a transfuziológie FN, Bratislava.
Vnitr Lek. 1998 Nov;44(11):649-53.
The problem of osteoporosis is world-wide in people above 50 years of age. As this period is also a risk period for the development of multiple myeloma or other malignant processes, comprehensive differential diagnosis of malignant and benign osteoporosis is essential. By retrospective analysis of a 12-year group of 270 patients treated by chemotherapy on account of multiple myeloma the authors selected a group of 151 patients treated in addition to chemotherapy and immunomodulating drugs (mixture of proteolytic enzymes-Wobe Mugos) for 2-3 years, also with biphosphonates. At the time ofdiagnosis osteoporosis was in 24.5% patients the only finding on bones. When biphosphonates (Bonefos, Ibandronate) and chemotherapy were administered during a three-year observation period the bone process was stable in 61.59%, osseous changes disappeared in 11.26% and progression of osteolysis was recorded in 27.15%. The objective of the work was to emphasize the importance of a correct diagnosis of osseous changes which can progress even in clinically asymptomatic myelomas.
骨质疏松问题在50岁以上人群中具有全球性。由于这个年龄段也是多发性骨髓瘤或其他恶性病变发展的风险期，因此对恶性和良性骨质疏松进行全面的鉴别诊断至关重要。通过对一组因多发性骨髓瘤接受化疗的270例患者进行为期12年的回顾性分析，作者选取了151例患者，这些患者除接受化疗和免疫调节药物（蛋白水解酶混合物——沃博·穆戈斯）治疗2 - 3年外，还使用了双膦酸盐。在诊断时，24.5%的患者骨质疏松是骨骼上唯一的表现。在为期三年的观察期内，当使用双膦酸盐（博宁、伊班膦酸钠）和化疗时，61.59%的患者骨病变稳定，11.26%的患者骨质改变消失，27.15%的患者出现骨质溶解进展。这项工作的目的是强调正确诊断骨病变的重要性，即使在临床无症状的骨髓瘤中骨病变也可能进展。
