Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Jagtvej 160, Copenhagen Ø DK-2100, Denmark; Sheffield Myeloma Research Team, Department of Oncology and Metabolism, Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK; Mellanby Centre for Bone Research, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK; Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
Sheffield Myeloma Research Team, Department of Oncology and Metabolism, Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK; Mellanby Centre for Bone Research, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK; Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
Semin Cell Dev Biol. 2021 Apr;112:49-58. doi: 10.1016/j.semcdb.2020.10.006. Epub 2020 Nov 4.
Multiple myeloma is a bone marrow neoplasia with an incidence of 6/100,000/year in Europe. While the disease remains incurable, the development of novel treatments such as autologous stem cell transplantation, proteasome inhibitors and monoclonal antibodies has led to an increasing subset of patients living with long-term myeloma. However, more than two thirds of patients suffer from bone pain, often described as severe, and knowledge on the pain mechanisms and its effect on their health-related quality of life (HRQoL) is limited. In this review, we discuss the mechanisms of myeloma bone disease, the currently available anti-myeloma treatments and the lessons learnt from clinical studies regarding HRQoL in myeloma patients. Moreover, we discuss the mechanisms of cancer-induced bone pain and the knowledge that animal models of myeloma-induced bone pain can provide to identify novel analgesic targets. To date, information regarding bone pain and HRQoL in myeloma patients is still scarce and an effort should be made to use standardised questionnaires to assess patient-reported outcomes that allow inter-study comparisons of the available clinical data.
多发性骨髓瘤是一种骨髓肿瘤，在欧洲的发病率为每 10 万人中有 6 人患病。虽然该疾病仍然无法治愈，但新型治疗方法的发展，如自体干细胞移植、蛋白酶体抑制剂和单克隆抗体的出现，使得越来越多的患者能够长期生存。然而，超过三分之二的患者患有骨痛，通常被描述为严重的骨痛，对疼痛机制及其对健康相关生活质量（HRQoL）的影响的了解有限。在这篇综述中，我们讨论了骨髓瘤骨病的机制、目前可用的骨髓瘤治疗方法以及从骨髓瘤患者的 HRQoL 临床研究中获得的经验教训。此外，我们还讨论了癌症引起骨痛的机制，以及骨髓瘤诱导的骨痛动物模型可以提供的识别新的镇痛靶点的知识。迄今为止，关于骨髓瘤患者的骨痛和 HRQoL 的信息仍然很少，应该努力使用标准化问卷来评估患者报告的结果，以便对现有临床数据进行跨研究比较。
