多发性骨髓瘤骨病临床诊疗专家共识（2021）

多发性骨髓瘤骨病(MBD)是多发性骨髓瘤(MM)患者的常见并发症,严重影响其生活质量和生存期,因此强调规范化的诊断和治疗。此次中国临床肿瘤学会(CSCO)指南工作委员会组织专家组,在2014版MBD专家共识的基础上进行了更新补充,推荐对于初治的MM患者,无论是否存在骨病的影像学证据,均应使用双膦酸盐和/或地舒单抗积极预防MBD及骨相关事件。在双膦酸盐使用期间,应该密切监测肾功能及颌骨改变,对于肾功能不全的患者需要减量甚至禁用,同时这类患者宜优先选用地舒单抗。希望本共识作为学术性指导意见,能够提供恰当的临床诊疗参考,以便使患者获得最佳的治疗,具体实施时应该根据患者的个体情况而定。

Chinese expert consensus on the diagnosis and management of multiple myeloma-related bone disease ( Version 2021)

Multiple myeloma-related bone disease(MBD)is a common complication in patients with multiple myeloma,which seriously affects their quality of life and survival.Thus standardized diagnosis and treatment are very important parts for MBD management.The multiple Myeloma-related Bone Disease Expert Group of CSCO has updated Chinese expert consensus based on the 2014 consensus,recommending that bisphosphonates or denosumab should be used for newly diagnosed multiple myeloma patients,with or without imaging evidence of bone disease,to prevent and treat MBD and the bone-related events.Renal function and jaw complications need to be closely monitored throughout the duration of use of bisphosphonates(BPs).Dose adjustments or even prohibition is essential in case of renal impairment,denosumab is recommended as first choice in such patients.This new consensus may provide appropriate clinical diagnosis and treatment guidance.Thus MBD patients may get the best treatment.But this consensus only acts as an academic guidance,the specific implementation is needed and must be based on the individuals'circumstances.