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Related Experiment Video

Updated: May 2, 2026

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Bone-modifying therapy in multiple myeloma: a comprehensive review.

Martina Bogeljić Patekar1, Vibor Milunović1, Inga Mandac Smoljanović1,2

  • 1Division of Hematology, Clinical Hospital Merkur, Zagreb, Croatia.

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|May 1, 2026
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Summary

Multiple myeloma (MM) causes bone lesions (SREs) due to plasma cell proliferation. This review covers SRE pathogenesis and treatments like bisphosphonates and denosumab, highlighting unmet needs in precision medicine.

Keywords:
biosimilarsbisphosphonatesbone pathogenesisdenosumabmultiple myelomaosteolysis

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Area of Science:

  • Hematologic Malignancies
  • Bone Biology
  • Pharmacology

Background:

  • Multiple myeloma (MM) involves plasma cell proliferation in bone marrow.
  • Skeletal-related events (SREs), characterized by osteolytic bone lesions, are a common and severe complication of MM.
  • MM disrupts bone homeostasis through various pathways and cytokines, leading to significant morbidity.

Purpose of the Study:

  • To review the pathogenesis of SREs in multiple myeloma.
  • To provide an overview of evidence-based, guideline-recommended treatments for SREs.
  • To identify unmet needs in the management of MM-related bone disease.

Main Methods:

  • Literature review of pathogenesis and treatment of SREs in MM.
  • Analysis of historical and current therapeutic strategies, including bisphosphonates and denosumab.
  • Discussion of emerging research and future directions in precision medicine for MM bone complications.

Main Results:

  • MM-induced bone lesions result from altered bone homeostasis.
  • Bisphosphonates were historically used but have limitations; denosumab is a viable alternative, though it has adverse events.
  • Anti-MM therapies may influence bone turnover, but data are preliminary.

Conclusions:

  • SREs are a major challenge in multiple myeloma management.
  • Current treatments like denosumab offer benefits but have drawbacks, and adverse events require attention.
  • There is a significant unmet need for advanced translational research and clinical trials to develop precision, risk-adapted therapies for MM bone disease.