Testing and management for monoclonal gammopathy of uncertain significance and myeloma patients presenting with osteoporosis and fragility fractures

Author:

Nador Guido1,Ramasamy Karthik12,Panitsas Fotios3,Pratt Guy4,Sadler Ross5,Javaid Muhammad Kassim6

Affiliation:

1. Department of Clinical Haematology, Oxford University Hospitals, Oxford, UK

2. NIHR, BRC Blood Theme, Oxford, UK

3. Haematology Department, Larissa University Hospital, Larissa, Greece

4. Haematology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham

5. Department of Immunology, Oxford University Hospitals, Oxford

6. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK

Abstract

AbstractMultiple myeloma, the second most frequent blood cancer, and its precursor, monoclonal gammopathy of uncertain significance, are associated with an increased risk of fragility fractures. However, current guidelines fail to offer explicit indications for healthcare professionals in terms of testing and thresholds for onward referral. The purpose of this review is to present the association of these conditions and metabolic bone disease and to highlight the importance of considering a diagnosis of monoclonal gammopathy of uncertain significance and myeloma in the context of a secondary fracture prevention assessment and of a multidisciplinary approach in managing these patients.

Publisher

Oxford University Press (OUP)

Subject

Pharmacology (medical),Rheumatology

Reference70 articles.

1. Multiple myeloma;Raab;Lancet,2009

2. Discovering the meaning of monoclonal gammopathy of undetermined significance: current knowledge, future challenges;Palladino;Transl Med UniSa,2014

3. Fracture risk in monoclonal gammopathy of undetermined significance;Melton;J Bone Miner Res,2004

4. Long-term risk of osteoporotic fracture in Malmo;Kanis;Osteoporos Int,2000

5. Epidemiology and economic burden of osteoporosis in UK;Ivergard;Arch Osteoporos,2013

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