[suzierose]

IF multiple myeloma is primarily a lytic disease of the bone how come...

by suzierose on Tue Oct 04, 2011 9:44 pm

If it is lack of osteoblast (build bone) activity and the osteoclasts (chew bone) are running wild chewing away at bone and making all the lesions unopposed that we don't just increase the osteoblasts?

Why can't the disease be treated by simply building up the bone with Zometa and keeping the patient hydrated to prevent the hypercalcemia that can evolve to renal dysfunction?

Are there experiments that show that building up osteoblast activity slows multiple myeloma progression?

Just wondering.

[Beacon Staff]

Re: IF multiple myeloma is primarily a lytic disease of the

by Beacon Staff on Wed Oct 05, 2011 10:18 am

Hi suzierose,

Zometa primarily blocks osteoclast activity (prevents bone degradation), rather than enhancing osteoblast activity (helping to build bone back up).

So far, no approved treatments have significant ability to rebuild bone. There are a few new drugs being tested in clinical trials for their ability to increase osteoblast activity and rebuild bone.

You may be interested in reading Dr. Roodman's column, in which he talks about recent advances in the treatment of myeloma bone disease:
https://myelomabeacon.org/news/2011/09/23/recent-advances-in-the-treatment-of-multiple-myeloma-bone-disease/

[suzierose]

Re: IF multiple myeloma is primarily a lytic disease of the

by suzierose on Sat Oct 08, 2011 3:21 pm

Thanks Beacon Staff.

I was wondering why Zometa can't be the SOLE therapy if the goal is to reduce bone lytic disease?

Do we need to reduce the plasma cells that are cancerous, if we contain the bone being eated away by the osteoclasts?

Could patients simply have radiolabelled cancerous plasma cells removed by electrophoresis or dialysis?

And the Zometa would keep the bones healthy?

[Dr. Peter Voorhees]

Re: IF multiple myeloma is primarily a lytic disease of the

by Dr. Peter Voorhees on Sat Oct 22, 2011 5:22 am

Dear Suzierose,

Zoledronic acid has been a very helpful addition to the toolbox (and in fact improved overall survival compared with clodronate, demonstrating that it does more than just protect bones), but it does have its limitations. Zoledronic acid reduces, but does not eliminate, the risk of bone related complications of myeloma. If the disease is allowed to grow largely unchecked, I do not think that zoledronic acid would prevent skeletal complications of the disease. In addition, bone disease is only one of the many symptoms of myeloma. If the disease were to progress, symptomatic anemia would ensue, the immune system would become increasingly dysfunctional, increasing the risk of infection, and the kidneys could shut down.
Reducing disease burden in conjunction with bisphosphonate therapy is the best way to go.

Take care!

Pete V.

[suzierose]

Re: IF multiple myeloma is primarily a lytic disease of the

by suzierose on Sat Oct 22, 2011 11:12 am

Thanks Dr. Voorhess.

I appreciate you responding with good information.

Guess we multiple myeloma patients do a lot of wishful thinking,