Management of Bone Disease and Kidney Failure in Multiple Myeloma : A Pocket Guide

This pocket guide provides a concise yet comprehensive overview of the two most prominent clinical features of multiple myeloma (MM), bone disease and renal failure. The first half of the text reviews critical aspects of bone disease in MM, including pathophysiology, the use of imaging modalities and drugs in treatment, and the role of orthopedic surgery in MM. The latter half of the book reviews major components of kidney disease in MM, from pathophysiology to treatment. Written by experts in the field, Management of Bone Disease and Kidney Failure in Multiple Myeloma: A Pocket Guide is a valuable resource for clinicians and practitioners who manage patients afflicted with multiple myeloma Preface Contents Contributors Chapter 1: Introduction: Management of Bone Disease and Kidney Failure in Multiple Myeloma References Chapter 2: The Pathophysiology of Myeloma Bone Disease: Bone Remodelling and the Role of Osteoclasts Introduction Normal Physiology of Bone Anatomy of Bone Extracellular Matrix Bone Cells Osteoclasts Osteoblasts Osteocytes Physiological Bone Remodelling The Pathophysiology of Myeloma Bone Disease Osteoclast-Activating Factors RANKL/RANK/OPG Macrophage Inflammatory Protein-1 Α (MIP-1Α) Interleukins (IL) Vascular Endothelial Growth Factor Osteopontin Other Factors Conclusion References Chapter 3: The Pathophysiology of Myeloma Bone Disease: Role of Osteoblasts and Osteocytes Introduction Pathophysiology of Myeloma-Induced Osteoblast Suppression Role of Exosomes in the Pathophysiology of MM-Induced OB Suppression Osteocytes and Myeloma Bone Disease Conclusion References Chapter 4: Imaging Techniques in Staging and Early Phases Introduction Whole Body X-Ray Whole Body Low-Dose CT MRI FDG PET/CT References Chapter 5: Imaging Techniques for Response Assessment and Follow-Up Introduction Scope of This Article Which Technique Should Be Used for Imaging-Based Response Evaluation? Anatomic Imaging FDG PET-CT DW-MRI FDG PET-CT vs DW-MRI Which Is the Optimal Time Point for Imaging During Follow-Up? Sensitivity, Specificity, and Standardization of Imaging for Response Evaluation Clinical Consequences Conclusions References Chapter 6: New Perspectives in Imaging Techniques New PET/CT Tracers Introduction Exploration of Metabolic Pathways Phenotype Tumor Imaging New Functional MRI Diffusion-Weighted MRI Introduction DW-MRI for Disease Detection Vs FDG-PET/CT DW-MRI for Assessment of Response to Therapy Dynamic Contrast-Enhanced MRI Introduction Prognostic Value of DCE-MRI DCE-MRI for Assessment of Response to Therapy Conclusion Bibliography Chapter 7: Therapy of Myeloma Bone Disease Introduction Physiopathology of Myeloma Bone Disease Deregulation of Osteocytes Increased Osteoclast Activity Suppressed Osteoblast Activity Bone Marrow Microenvironment Treatment of Myeloma Bone Disease Bisphosphonates Denosumab Anti-sclerostin Antibodies Conclusion References Chapter 8: Orthopaedic Management in Multiple Myeloma: What Is the Role and When? Introduction Presentation Case Examples of Presenting Features Pathological Fracture Leading to New Diagnosis Pain and Abnormal X-Ray, with Normal Myeloma Screen Summary of the Principles of Management Staging and Confirmation of Diagnosis via Bone Biopsy Decision-Making Orthopaedic Management Options Nonoperative Operative Types of Implants and Reconstruction Internal Fixation (Figs. 8.8, 8.9, 8.10 and 8.11) Resection and Replacement Surgery (Figs. 8.12 and 8.13) Risks References Chapter 9: The Pathophysiology of Kidney Involvement in Multiple Myeloma and Monoclonal-Related Disorders Epidemiology of Renal Injury in Multiple Myeloma (MM) and Monoclonal-Related Disorders Clinical Presentation Immunoglobulins and Free Light Chain Physiology FLC Metabolism and Mechanisms of Injury During Monoclonal Clone-Related Disorders Histopathological Lesions in Monoclonal Clone-Related Disorders Lesions with Organized Deposits Lesions with Non-organized Deposits Lesions Without Deposits Therapeutic Insights Kidney Transplant References Chapter 10: Treatment of Multiple Myeloma with Kidney Involvement Evidence Base General Principles Prompt Assessment High-Quality Supportive Care Rapid Reduction in Circulating Serum FLC Levels Mechanical Removal of Circulating Free Light Chains Plasma Exchange High Cut-Off (HCO) Dialysis Chemotherapeutic Approach Single Agent Dexamethasone Bortezomib Other Proteasome Inhibitors Carfilzomib Ixazomib Immunomodulatory Drugs Thalidomide Lenalidomide Pomalidomide HDAC Inhibitors Monoclonal Antibodies Autologous Stem Cell Transplantation Considerations for the Future Proximal Tubule Injury as a Potential Therapeutic Target Free Light Chain-Uromodulin Interaction as a Potential Therapeutic Target Summary References Correction to: The Pathophysiology of Myeloma Bone Disease: Bone Remodelling and the Role of Osteoclasts Index