Myeloma bone disease and other hematological malignancies

This chapter discusses the pathophysiology of skeletal lesions in hematological malignancies, with a focus on the current understanding of their associated bone disease, and includes brief discussions of radiological imaging of skeletal lesions, pharmacological treatments, and other hematological malignancies that affect bone. Multiple myeloma (MM) is a plasma cell malignancy characterized by monoclonal paraprotein production from terminally differentiated plasma cells and lytic bone disease. MM has the highest incidence of bone involvement amongst malignant diseases, and is the second most common hematological malignancy, accounting for approximately 15% of all hematological malignancies. MGUS is a premalignant monoclonal plasma cell disorder that produces no overt symptoms, but is associated with an annual risk of progression to myeloma of approximately 1%. Adult T-cell leukemia/lymphoma (ATLL) is a malignancy of CD4+ T cells caused by infection with human T-cell leukemia virus type 1 (HTLV-1). Bone involvement in Hodgkin disease (HD) is also uncommon and seldom encountered at diagnosis.