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多发性骨髓瘤相关骨病管理多学科方法的专家共识

Expert consensus on a multidisciplinary approach for the management of multiple myeloma-related bone disease.

作者信息

Wang Yutong, Xu Qiming, Li Yuan, Su Yongbin, Wang Ling, Wang Xiaoquan, Ge Jian, Jing Hongmei, Guo Yuxing, Chen Yalin, Li Xianan, Zhuang Jun-Ling, Tan Jing, Wang Xiaobo, Zhong Liye, Luo Jun, Zhao Peng, Fan Shengjin, Ren Jinhai, Yang Haiping, Mei Heng, Sun Chunyan, Li Chunrui, Sun Xuemei, Lu Xuechun, Gao Guangxun, Zhou Zeping, Pan Yaozhu, Sun Ying, Hong Zhang, Liu Zhiqiang, Ma Yanping, Wang Yi, Sun Wei, Hou Jian, Mi Jianqing, Chen Wenming, Huang Xiaobing, Li Bingzong, Fu Rong, Shi Jumei, Ran Xuehong, Zhou Fuling, He Aili, Mao Min, Cai Zhen, Li Nan, Xu Meng, Yan Xiaojing, Yang Wei, An Gang, Gong Lihua, Sun Lichao, Li Zhihong, Liu Tang, He Yanjuan, Yin Junqiang, Liu Yao, Liu Weifeng, Bao Li

机构信息

Department of Hematology, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100031, China.

Department of Orthopedic Oncology, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100031, China.

出版信息

Cancer Pathog Ther. 2024 Dec 18;3(4):280-292. doi: 10.1016/j.cpt.2024.12.002. eCollection 2025 Jul.

Abstract

This consensus on multiple myeloma-related bone diseases (MBDs) underscores the importance of a multidisciplinary approach that encompasses hematology, radiology, orthopedics, and additional specialties to tackle its intricate challenges. MBD, a prevalent and debilitating complication of multiple myeloma, leads to bone pain, fractures, and skeletal-related events (SREs), which profoundly impact patients' quality of life. The guidelines offer a thorough framework for diagnosis, treatment, and continual assessment, emphasizing early detection and consistent monitoring using imaging techniques such as positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI). Treatment strategies prioritize the careful application of anti-myeloma agents, bisphosphonates, and denosumab to minimize bone loss and decrease SRE risk, complemented by surgical and radiotherapy interventions for structural or pain-related issues. Supportive care measures, including pain management, rehabilitation, nutritional support, and dental evaluations, play a crucial role in enhancing patient outcomes and preserving quality of life. This consensus advocates a standardized, evidence-based approach to managing MBD, ensuring comprehensive and coordinated care for patients.

摘要

关于多发性骨髓瘤相关骨病(MBDs)的这一共识强调了多学科方法的重要性,该方法涵盖血液学、放射学、骨科及其他专业,以应对其复杂挑战。MBD是多发性骨髓瘤常见且使人衰弱的并发症,会导致骨痛、骨折和骨相关事件(SREs),对患者的生活质量产生深远影响。这些指南为诊断、治疗和持续评估提供了全面框架,强调使用正电子发射断层扫描-计算机断层扫描(PET-CT)和磁共振成像(MRI)等成像技术进行早期检测和持续监测。治疗策略优先谨慎应用抗骨髓瘤药物、双膦酸盐和地诺单抗,以尽量减少骨质流失并降低SRE风险,同时辅以针对结构或疼痛相关问题的手术和放疗干预。支持性护理措施,包括疼痛管理、康复、营养支持和牙科评估,在改善患者预后和维持生活质量方面发挥着关键作用。这一共识倡导采用标准化、基于证据的方法来管理MBD,确保为患者提供全面、协调的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1d9/12277822/603f260ffbbf/gr1.jpg

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