Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Oncology, Hematology, myeloma, bone markers, NTX, CTX, ICTP, CARBOXY-TERMINAL TELOPEPTIDE, RESISTANT ACID-PHOSPHATASE, SERUM OSTEOPROTEGERIN LEVELS, SKELETAL-RELATED EVENTS, I COLLAGEN ICTP, RESORPTION MARKERS, ZOLEDRONIC ACID, ISOFORM 5B, DEGRADATION-PRODUCTS, OSTEOLYTIC LESIONS, Biomarkers, Bone Remodeling, Humans, International Agencies, Multiple Myeloma, International Myeloma Working Group, 1103 Clinical Sciences, 1112 Oncology and Carcinogenesis, Immunology, 3201 Cardiovascular medicine and haematology, 3202 Clinical sciences, 3211 Oncology and carcinogenesis

Abstract:

Lytic bone disease is a frequent complication of multiple myeloma (MM). Lytic lesions rarely heal and X-rays are of limited value in monitoring bone destruction during anti-myeloma or anti-resorptive treatment. Biochemical markers of bone resorption (amino- and carboxy-terminal cross-linking telopeptide of type I collagen (NTX and CTX, respectively) or CTX generated by matrix metalloproteinases (ICTP)) and bone formation provide information on bone dynamics and reflect disease activity in bone. These markers have been investigated as tools for evaluating the extent of bone disease, risk of skeletal morbidity and response to anti-resorptive treatment in MM. Urinary NTX, serum CTX and serum ICTP are elevated in myeloma patients with osteolytic lesions and correlate with advanced disease stage. Furthermore, urinary NTX and serum ICTP correlate with risk for skeletal complications, disease progression and overall survival. Bone markers have also been used for the early diagnosis of bone lesions. This International Myeloma Working Group report summarizes the existing data for the role of bone markers in assessing the extent of MM bone disease and in monitoring bone turnover during anti-myeloma therapies and provides information on novel markers that may be of particular interest in the near future.