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多发性骨髓瘤(第二部分)——骨病治疗进展

Multiple Myeloma (Part 2) - Update on The Approach to Bone Disease.

作者信息

Guedes Alex, Becker Ricardo Gehrke, Teixeira Luiz Eduardo Moreira

机构信息

Grupo de Oncologia Ortopédica, Hospital Santa Izabel, Santa Casa de Misericórdia da Bahia, Salvador, BA, Brasil.

Serviço de Trauma Ortopédico, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2023 Jun 29;58(3):368-377. doi: 10.1055/s-0043-1770150. eCollection 2023 Jun.

Abstract

The increase in life expectancy of the world population has led to a concomitant increase in the prevalence of multiple myeloma (MM), a disease that usually affects the elderly population. Bone lesions are frequent in patients with this condition, demanding an early approach, from drug treatment, through radiotherapy to orthopedic surgery (prophylactic or therapeutic) with the objective of preventing or delaying the occurrence of fracture, or, when this event has already occurred, treat it through stabilization or replacement (lesions located in the appendicular skeleton) and/or promote stabilization and spinal cord decompression (lesions located in the axial skeleton), providing rapid pain relief, return to ambulation and resocialization, returning quality of life to patients. The aim of this review is to update the reader on the findings of pathophysiology, clinical, laboratory and imaging, differential diagnosis and therapeutic approach of multiple myeloma bone disease (MMBD).

摘要

世界人口预期寿命的增加导致多发性骨髓瘤(MM)的患病率随之上升,该病通常影响老年人群。骨病变在这种疾病的患者中很常见,需要早期干预,从药物治疗、放射治疗到骨科手术(预防性或治疗性),目的是预防或延迟骨折的发生,或者当骨折已经发生时,通过固定或置换(位于四肢骨骼的病变)进行治疗和/或促进脊柱稳定及脊髓减压(位于轴向骨骼的病变),迅速缓解疼痛,恢复行走能力和重新融入社会,使患者恢复生活质量。本综述的目的是向读者介绍多发性骨髓瘤骨病(MMBD)的病理生理学、临床、实验室和影像学、鉴别诊断及治疗方法的研究结果。

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