Lifting the Veil on Myeloma Bone Disease

Review Lifting the Veil on Myeloma Bone Disease Rui Chen 1, Rui Liu 1, and Huan Liu 1,2,* 1 Cancer Research Center, School of Medicine, Xiamen University, Xiamen 361102, China 2 Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen 361102, China * Correspondence: huanliu@xmu.edu.cn Received: 13 November 2024; Revised: 29 November; Accepted: 13 January 2025; Published: 23 January 2025 Abstract: Multiple myeloma (MM), a hematological malignancy originating from malignant plasma cells in the bone marrow, predominantly affects the elderly, and its incidence is on the rise. It is currently the second most common hematological malignancy. Osteolytic bone disease, a severe complication detected in nearly 80% of myeloma patients, affects the entire skeletal system, particularly the skull, spine, pelvis, and long bones of the limbs. This condition causes pathological fractures, severe bone pain, spinal cord compression, and hypercalcemia. The management of bone damage in myeloma patients presents numerous challenges, with current clinical treatments primarily relying on bisphosphonates and anti-RANKL monoclonal antibodies (Denosumab). This review summarizes recent advancements in research on myeloma and bone damage, focusing on the complex interactions between myeloma cells and various other cell types that affect the skeleton. It also discusses the challenges encountered in bone damage research, highlighting potential future research directions and proposing therapeutic strategies.