Treatment of multiple myeloma-related bone disease: recommendations from the Bone Working Group of the International Myeloma Working Group

In this Policy Review, the Bone Working Group of International Myeloma updates its clinical practice recommendations for management multiple myeloma-related bone disease. After assessing available literature and grading using Grading Recommendations, Assessment, Development, Evaluations (GRADE) method, experts from working group recommend zoledronic acid as preferred bone-targeted agent patients with newly diagnosed myeloma, or without Once achieve a very good partial response better, after receiving monthly at least 12 months, treating physician can consider decreasing frequency discontinuing treatment. Denosumab also be considered treatment disease, particularly in renal impairment. might prolong progression-free survival myeloma who have disease are eligible autologous stem-cell transplantation. discontinuation is challenging due to rebound effect. The found cement augmentation effective painful vertebral compression fractures. Radiotherapy recommended uncontrolled pain, impeding symptomatic spinal cord compression, pathological Surgery should used prevention restoration long-bone fractures, column instability, fragments within route.