Multiple myeloma is a plasma cell malignancy characterized by the frequent development
of osteolytic bone lesions. The multiple myeloma–induced bone destruction is a result
of the increased activity of osteoclasts that occurs adjacent to multiple myeloma
cells. This activity is accompanied by suppressed osteoblast differentiation and activity,
resulting in severely impaired bone formation and development of devastating osteolytic
lesions. Recently the biologic mechanism involved in the imbalance between osteoclast
activation and osteoblast inhibition induced by multiple myeloma cells has begun to
be clarified. In this article, the pathophysiology underlying the imbalanced bone
remodeling and potential new strategies for the treatment of bone disease in multiple
myeloma are reviewed.
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