Multiple myeloma is the most frequent cancer to involve the skeleton, with up to 80 percent of patients having bone disease. Although fewer patients appear to have bone involvement more recently, it is still a major source of both complications and death among patients with myeloma.

Bone disease is so severe in myeloma because the normal bone remodeling process is disrupted. In normal individuals, damaged bone is removed by bone-destroying cells, the osteoclasts, and then bone is replaced by bone-forming cells, the osteoblasts. In myeloma, the number and activity of the bone-destroying …