Multiple Myeloma Bone Lesions Prognosis
Causes of Bone Destruction in Myeloma
Normally, osteoclasts function with bone-forming cells, called osteoblasts, to restore areas of bone that are wearing out (fatigue). This process is called bone remodeling and healthy bone constantly reconstructs.The destruction of bone osteolytic lesions are caused by two separate events. The rapid growth of myeloma cells inhibits normal bone-forming cells, damaging bone. In addition, the increased production of substances that activate the cells that resorbent bone, called osteoclasts. Osteoclasts normally destroy old or worn out bone and work with bone-forming cells for bone repair. In the case of multiple myeloma, however, excessive osteoclast activity causes bone loss with concomitant loss of bone repair and growth from the suppression of bone formation.
1. The Activity of Bone Cells in Myeloma. Typically, the activity of osteoclasts and osteoblasts is well balanced, the osteoclasts clear fatigue bone and the osteoblasts begin to rebuild a new bone. In patients with multiple myeloma, bone resorption by the osteoclasts is increased and exceeds bone reformation. Calcium lost from the bones appears in increasing amounts in the serum and urine of the patient. This increased bone resorption can lead to pain, fractures, spinal cord compression, and hypercalcemia. Some lesions of bone multiple myeloma can be treated with bisphosphonates or radiation therapy.
In myeloma, there is an increased activity of osteoclasts caused by factors, called osteolytic activating factors or OAF. It is known that these osteoclastic activating factors are tumor cells.
2. The Bone marrow Microenvironment and its role in Bone Resorption. The microenvironment of the bone marrow is the area in the bones (the marrow) where stem cells develop into blood cells and cells of the immune system. In multiple myeloma, the bone marrow microenvironment is the area in which they develop and grow malignant plasma cells. An important and promising area of research is myeloma study ways to make the bone marrow microenvironment less hospitable to myeloma cells. The microenvironment of the bone marrow plays an important role in increasing bone resorption, which occurs when myeloma.
The stage is a way of describing where the cancer is located if or where it has spread, and whether it affects other parts of the body. Doctors use diagnostic tests to determine the cancer stage so staging may not be complete as long as all tests are completed. Knowing the stage helps the doctor to decide what treatment is best and can help predict the prognosis of the patient, which is a chance for recovery. There are different stage descriptions for different types of cancer.
For myeloma it is important, to begin with, does the patient feel symptoms. It is common to classify people with newly diagnosed myeloma as symptomatic of the disease (symptoms and signs) or asymptomatic (without any symptoms). Patients without symptoms, as a rule, closely without specific treatment, although sometimes there are treatments to stop the disease from growing or spreading. This is called the active monitoring of smoldering myeloma. Patients with symptoms or who develop symptoms that need treatment.
Symptoms associated with myeloma describes the mnemonic CRAB. These include hypercalcemia (high calcium level in the blood), poor kidney function or kidney failure, anemia and bone pain or bone damage.
Multiple Myeloma Bone Lesions Prognosis / Forecast
ISS myeloma gives information about prognosis and predicts the person's chance for recovery. Researchers are also looking at other ways to predict the prognosis for people with multiple myeloma. Some of the existing approaches to the assessment of the forecast include:- High levels of β2-M may indicate that there is a large number of cells of myeloma and the kidney damage occurred. The level of this protein increases when the myeloma becomes more advanced.
- Lower amounts of serum albumin may indicate a weaker prediction.
- Lactate dehydrogenase (LDH) is an enzyme. A higher level of LDH in the blood indicates a weaker forecast.
- Abnormalities of chromosomes (cytogenetics) in cancer cells can show how aggressive the cancer is. This approach to testing the genetics of myeloma includes FISH.
- The labeling index of plasma cells can be performed in a specialized laboratory using bone marrow samples to find out how fast cancer cells grow.
Multiple myeloma is a serious condition, but cancer and subsequent bone damage can cause serious long-term effects. The most obvious of these long-term effects are bone weakness and chronic pain. The lesions and patches of soft bones that occur as a result of myeloma are difficult to treatable and can cause an advanced fracture, although myeloma himself has become a forgiving.
If the tumor pushes the nerve or causes compression of the spinal cord, it may cause long-term damage to the nervous system. Due to the fact that some myeloma treatment may also cause nerve damage, many people develop tingling or pain in areas of nerve damage. Treatment is available as a supportive aid, such as Pregabalin (Lyrica) or duloxetine (Cymbalta). You can also wear loose socks and soft sandals and walk regularly to help alleviate the pain.