Bosphorus Med J. 2020; 7(2): 70-74 | DOI: 10.14744/bmj.2020.65365

Bone Pathology in Multiple Myeloma: Diagnosis and Treatment

Erhan Okay, Korhan Özkan
Istanbul Medeniyet University Goztepe Education and Research Hospital, Department of Orthopaedics, Istanbul

Multiple myeloma is the most common primary bone disease. Incidence has been reported as 3/100.000 in the United States. This neoplasia is characterized by osteolytic bone destruction and monoclonal proliferation of plasma cells. Multiple myeloma is the most common haematologic malignancy after Non-Hodgkin lymphoma and the most common primary bone malignancy in elderly population. Orthopaedic complaints include pain, pathologic fracture, osteoporosis, hypercalcemia and spinal cord compression. Chemotherapy constitutes the main treatment. Surgical intervention should be as minimal as possible and chemotherapy should be started as soon as possible. The risk of infection should also be considered. This review aimed to synthesize the diagnosis and treatment of bone involvement in myeloma disease.

Keywords: Chemotherapy, intramedullary nailing; myeloma; osteolytic bone destruction; pathologic fracture.

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Multiple Miyelomda Kemik Tutulumunun Taný ve Tedavisi

Erhan Okay, Korhan Özkan
Istanbul Medeniyet Üniversitesi Göztepe Eðitim ve Araþtýrma Hastanesi, Ortopedi Anabilim Dalý, Ýstanbul

Multiple miyelom kemiðin en sýk primer tümörü olup, Amerika Birleþik Devletleri’ndeki insidansý 3/100.000’dir. Plazma hücrelerinin monoklonal proliferasyonu ve kemik iliðinin infiltrasyonu ile karakterize osteolitik kemik hasarý meydana getiren bir neoplazidir. Multiple miyelom, Non-Hodgkin lenfomadan sonra en sýk görülen hematolojik habis tümör iken, yaþlý popülasyonda ise en sýk gözlenen primer kemik tümörüdür. Ortopedik þikayetler arasýnda aðrý, patolojik kýrýk, osteoporoz ve spinal kord basýsý yer almaktadýr. Asýl tedaviyi kemoterapi oluþturmaktadýr. Yapýlacak cerrahi giriþim mümkün olduðu kadar minimal olmalý ve kemoterapi olabildiðince erken baþlanmalýdýr. Enfeksiyon riski gözönüne alýnmalýdýr. Bu derlemede multiple miyelomlu hastalarda kemik tutulumunun taný ve tedavisinin özetlenmesi amaçlandý.

Anahtar Kelimeler: Ýntrameduller çivileme, kemoterapi; miyeloma; osteolitik kemik hasarý; patolojik kýrýk.

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