The role of bone metabolism parameters in the assessment of myeloma bone disease


Authors: V. Ščudla 1;  P. Petrová 2;  P. Lochman 2;  J. Minařík 1;  T. Pika 1;  J. Bačovský 1
Authors‘ workplace: III. interní klinika-nefrologická, revmatologická a endokrinologická FN a LF UP Olomouc 1;  Oddělení klinické biochemie FN a LF UP Olomouc 2
Published in: Klin. Biochem. Metab., 21 (42), 2013, No. 2, p. 71-78

Overview

The aim of this contribution is to present up to date information regarding bone metabolism in multiple myeloma (MM). Special attention is dedicated to the general role of bone remodellation markers in the assessment of myeloma bone disease (MBD), and the parameters of bone resorption and osteogenesis from the point of their significance in clinical practice. Individual chapters aim at the relationship of bone resorption and osteogenesis markers to the severity of MBD, and to the stage, grade, activity and prognosis of multiple myeloma, and differences between monoclonal gammopathy of undetermined significance (MGUS) and MM. Interest is dedicated to the contribution of monitoring of bone resorption markers, i.e. S-ICTP and U-NTX, and not very satisfactory significance of osteogenesis markers, i.e. S-bALP and S-osteocalcin in the course of MM treatment including anti-resorption treatment with bisphosphonates. We present information about new and perspective molecules involved in bone remodellation process in MM, i.e. RANKL/osteoprotegerin index, Dickkopf-1 (Dkk-1), activin-A and osteosclerostin. The outcome of the paper is the summary of convenient markers of bone metabolism, recommended for the use in standard clinical practice by International Myeloma Working Group.

Keywords:
multiple myeloma, myeloma bone disease, bone resorption markers (S-ICTP, U-NTX, S-TRACP-5b), osteogenesis markers (S-bALP, S-osteocalcin), RANKL/osteoprotegerin, DKK-1, therapy.


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