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多发性骨髓瘤及双膦酸盐在其治疗中的作用

Multiple Myeloma and the Role of Bisphosphonates in Its Management.

作者信息

Tanveer Nida, Hussein Sally, Pingili Shravya, Makkena Vijaya Krishna, Jaramillo Arturo P, Awosusi Babatope L, Ayyub Javaria, Dabhi Karan Nareshbhai, Gohil Namra V, Hamid Pousette

机构信息

Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Medicine, Kakatiya Medical College, Hyderabad, IND.

出版信息

Cureus. 2023 Sep 14;15(9):e45270. doi: 10.7759/cureus.45270. eCollection 2023 Sep.

Abstract

An aberrant growth of plasma cells in the bone marrow characterizes the hematological neoplasm known as multiple myeloma, which is typically accompanied by increased bone pain and skeletal-related events such as pathological fractures and/or spinal cord compression. Changes in the bone marrow microenvironment brought on by increased osteoclastic activity and/or decreased osteoblastic activity as a result of myeloma bone disease have a detrimental effect on quality of life. Bone-modifying medications such as bisphosphonates or denosumab are used to treat myeloma bone disease. These substances can lessen bone pain and the chance of pathological fracture, but they do not stimulate the growth of new bone or heal already damaged bone. In order to conduct this study, we searched the PubMed, Google Scholar, and Cochrane databases for complete free papers published in English and studied people over the previous five years, starting in 2018. The search covered randomized clinical trials (RCT), observational studies, meta-analyses, systemic reviews, and conventional reviews. Twenty-five publications are picked after using quality evaluation techniques to determine the type of study. These papers' full-text articles are investigated, examined, and tallied. We spoke about the various treatments for bone damage in multiple myeloma. It was discovered that bisphosphonates lessen the frequency and severity of bone problems. However, we are unsure of their contribution to survival. Although these medicines enhance life quality, it is unknown if they also increase overall survival. The focus of this study is on several kinds of bone-modifying drugs, their processes of action, the point at which therapy is started, how long it lasts, and any possible mortality advantages.

摘要

骨髓中浆细胞的异常增殖是血液肿瘤多发性骨髓瘤的特征,多发性骨髓瘤通常伴有骨痛加剧和骨骼相关事件,如病理性骨折和/或脊髓压迫。由于骨髓瘤骨病导致破骨细胞活性增加和/或成骨细胞活性降低,进而引起的骨髓微环境变化对生活质量产生不利影响。双膦酸盐或地诺单抗等骨修饰药物用于治疗骨髓瘤骨病。这些物质可以减轻骨痛和病理性骨折的几率,但它们不会刺激新骨生长或修复已受损的骨骼。为了开展本研究,我们在PubMed、谷歌学术和考科蓝数据库中搜索了2018年以来过去五年以英文发表的完整免费论文,并研究了相关人群。搜索涵盖随机临床试验(RCT)、观察性研究、荟萃分析、系统评价和传统综述。在使用质量评估技术确定研究类型后,挑选出25篇出版物。对这些论文的全文进行调查、审查和统计。我们讨论了多发性骨髓瘤骨损伤的各种治疗方法。发现双膦酸盐可降低骨问题的发生率和严重程度。然而,我们不确定它们对生存的贡献。尽管这些药物可提高生活质量,但它们是否也能提高总生存率尚不清楚。本研究的重点是几种骨修饰药物、它们的作用过程、治疗开始的时间点、持续时间以及任何可能的生存优势。

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本文引用的文献

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Multiple Myeloma and Bone: The Fatal Interaction.多发性骨髓瘤与骨骼:致命交互。
Cold Spring Harb Perspect Med. 2018 Aug 1;8(8):a031286. doi: 10.1101/cshperspect.a031286.

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