Fractures and Survival in Multiple Myeloma: Results from a Population-Based Study

Þorsteinsdóttir, Sigrún; Gislason, Gunnar; Aspelund, Thor; Sverrisdottir, Ingigerdur Solveig; Landgren, C. Ola; Turesson, Ingemar; Björkholm, Magnus; Kristinsson, Sigurður Y.

doi:10.1016/j.clml.2019.09.052

Cited by 11 publications

(16 citation statements)

References 22 publications

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“…Furthermore, the risk of death for elderly MM patients ≥70 years of age at the time of MM diagnosis with a fracture was significantly increased compared to those without. 16 Results from other studies are in line with these and these authors observed that pathological fractures increase the risk of death by 20-40%. 17 Underlying causes for the observations of Thorsteinsdottir et al are plentiful, the most likely being that SRE may hamper intensified systemic anti-MM treatment and impair patient constitution/fitness levels.…”

supporting

confidence: 80%

“…12 The successful story of these newly introduced therapeutic approaches include B-cell-depleting monoclonal antibodies that inhibit autoantibody production, 13 and nanobodies that bind to the VWF A1 domain and inhibit the VWFplatelet glycoprotein Ib interaction. 14,15 Recently, a recombinant form of human ADAMTS13 was successfully tested in a pharmacokinetics and safety study in 15 patients with cTTP 16 and is expected to facilitate the management of cTTP and possibly iTTP in the near future. This ongoing development illustrates the strength of translational medicine when basic science and clinical research combine efficiently.…”

Section: Animal Models Of Thrombotic Thrombocytopenic Purpura: the Tamentioning

confidence: 99%

“…10,11,15 In this issue of the journal, Thorsteinsdottir et al report results of their large retrospective population-based study "Fractures and Survival in Multiple Myeloma". 16 They used data from 14,013 MM patients diagnosed in Sweden in the years 1990-2013, who had been identified by the Cancer Registry. Information on date of birth, MM diagnosis, fractures, and death were collected from central registries.…”

mentioning

confidence: 99%

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Prevention of bone disease and early detection of impending fractures in multiple myeloma patients can reduce morbidity and mortality: the necessity of interdisciplinary state-of-the-art treatment

Herget¹,

Wäsch²,

Klein³

et al. 2020

Haematologica

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supporting

confidence: 80%

Section: Animal Models Of Thrombotic Thrombocytopenic Purpura: the Tamentioning

confidence: 99%

mentioning

confidence: 99%

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Prevention of bone disease and early detection of impending fractures in multiple myeloma patients can reduce morbidity and mortality: the necessity of interdisciplinary state-of-the-art treatment

Herget¹,

Wäsch²,

Klein³

et al. 2020

Haematologica

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“…Previous analyses suggested that diagnostic delays are associated with worse clinical outcomes [20][21][22][23][24][25]. A recent study reported that skeletal-related events (SRE) in newly diagnosed MM patients occur very frequently: two-thirds of patients had a SRE before study enrollment; additionally, 44% had at least one onstudy SRE, with 60% of all first SREs occurring within the first 3 months and 81% occurring within the first 6 months [26].…”

Section: Discussionmentioning

confidence: 99%

Interdisciplinary approach to multiple myeloma – time to diagnosis and warning signs

Herget

Kälberer

Ihorst

et al. 2020

Leukemia & Lymphoma

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Delayed diagnosis is a common challenge in the management of multiple myeloma (MM). This prospective interdisciplinary study evaluated symptoms and time to diagnosis (TTD) in 81/295 screened patients at our tertiary center, who were examined by an orthopedist prior to the MM diagnosis. The most frequent complaint was back pain (81%), mainly localized thoracic and/or lumbar. Pain was independent of movement in 85%, occurred at night in 69%, and at multiple localizations in 30% of patients. Notably, 63% patients with an orthopedic disease noticed substantial symptom change before the MM diagnosis was made. The median TTD was 7 months and did not differ significantly between patients with or without a preexisting skeletal disease. To avoid delayed diagnosis, physicians should consider MM as a differential diagnosis, whenever warning signs such as skeletal pain independent from movement, at night, at various localizations, and change in pain characteristics accompanied by fatigue, are reported.

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“…Among the patients diagnosed with multiple myeloma (MM), 80% already suffer from MM bone disease, exhibiting osteolytic bone tissue destruction or osteopenia, with symptoms of severe pain and fractures [ 1 ]. Morbidity and mortality due to MM bone disease are high, and quality of life is severely affected by skeletal-related pathologies [ 1 , 2 ]. MM is rarely curable and is the second most common hematological neoplasia in the USA and Europe with an age-adjusted incidence of six per 100,000 people/year and a median age of 69 [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

An Early Myeloma Bone Disease Model in Skeletally Mature Mice as a Platform for Biomaterial Characterization of the Extracellular Matrix

Ziouti

Soares

Moreno-Jiménez

et al. 2020

Journal of Oncology

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Multiple myeloma (MM) bone disease is characterized by osteolytic bone tissue destruction resulting in bone pain, fractures, vertebral collapse, and spinal cord compression in patients. Upon initial diagnosis of MM, almost 80% of patients suffer from bone disease. Earlier diagnosis and intervention in MM bone disease would potentially improve treatment outcome and patient survival. New preclinical models are needed for developing novel diagnostic markers of bone structural changes as early as possible in the disease course. Here, we report a proof-of-concept, syngeneic, intrafemoral MOPC315.BM MM murine model in skeletally mature BALB/c mice for detection and characterization of very early changes in the extracellular matrix (ECM) of MM-injected animals. Bioluminescence imaging (BLI) in vivo confirmed myeloma engraftment in 100% of the animals with high osteoclast activity within 21 days after tumor cell inoculation. Early signs of aggressive bone turnover were observed on the outer bone surfaces by high-resolution microcomputed tomography (microCT). Synchrotron phase contrast-enhanced microcomputer tomography (PCE-CT) revealed very local microarchitecture differences highlighting numerous active sites of erosion and new bone at the micrometer scale. Correlative backscattered electron imaging (BSE) and confocal laser scanning microscopy allowed direct comparison of mineralized and nonmineralized matrix changes in the cortical bone. The osteocyte lacunar-canalicular network (OLCN) architecture was disorganized, and irregular-shaped osteocyte lacunae were observed in MM-injected bones after 21 days. Our model provides a potential platform to further evaluate pathological MM bone lesion development at the micro- and ultrastructural levels. These promising results make it possible to combine material science and pharmacological investigations that may improve early detection and treatment of MM bone disease.

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Fractures and Survival in Multiple Myeloma: Results from a Population-Based Study

Cited by 11 publications

References 22 publications

Prevention of bone disease and early detection of impending fractures in multiple myeloma patients can reduce morbidity and mortality: the necessity of interdisciplinary state-of-the-art treatment

Prevention of bone disease and early detection of impending fractures in multiple myeloma patients can reduce morbidity and mortality: the necessity of interdisciplinary state-of-the-art treatment

Interdisciplinary approach to multiple myeloma – time to diagnosis and warning signs

An Early Myeloma Bone Disease Model in Skeletally Mature Mice as a Platform for Biomaterial Characterization of the Extracellular Matrix

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