Skeletal impairment in patients with multiple myeloma, review for period of five years 2007–2011 in Koroška region

• Main Authors: Irena Umek Bricman, Frosina Krstanoska, Betka Popič, Ivo Bricman
• Format: Article
• Language: English
• Published: Slovenian Medical Association 2012-12-01
• Series: Zdravniški Vestnik
• Online Access: http://vestnik.szd.si/index.php/ZdravVest/article/view/742

Background: Multiple myeloma (MM) is a malignant haematological disease which is characterized by proliferation of plasma cell clone in the bone marrow. Among other symptoms of the disease, the important one is bone destruction with pain, pathological fractures and hypercalcemia. Methods: Retrospectively, we collected data on patients with MM treated in the period from 1 January 2007 until 31 December 2011. Diagnosis was confirmed de novo in 19 patients. We treated 15 patients (89 %), 3 patients (16 %) died soon after being diagnosed, without starting the therapy; 1 patient (5 %) continued treatment at the Institute of Oncology and at the Department of Haematology in Ljubljana. All patients received bisphosphonates. Bone disease was diagnosed by x- ray, and in case of pathology, an additional CT scan was performed. At the beginning we found skeletal impairment in 17 / 19 patients (89 %), 5 patients had pathological fractures of the spine and 1 patient destruction of the pelvis. 4 / 19 patients (21 %) had hypercalcemia. All patients were treated with chemotherapy and supporting therapy with bisphosphonates, and despite of that, 6/15 experienced extra fractures. Two patients were operated on, all of them were locally irradiated, immobilized and received analgesics. Conclusions: Supportive therapy with bisphosphonates is an important part of specific treatment for MM. With the availability of additional imaging by MRI or PET CT scan we can diagnose more bone impairments.