[Management of bone lesions in multiple myeloma].

Bone destruction is a key feature of multiple myeloma, which causes significant impairment of patients' activity. Some of the mechanisms regulating bone destruction have recently been clarified, and the management of bone diseases in myeloma patients has made considerable progress. Moreover,imaging techniques for screening bone lesions have been developed, such as PET scan or (99m)Tc scan, other than regular X-ray analysis. We describe here strategies for the management of bone disease in myeloma, e.g., ( I ) effective chemotherapy against myeloma cells, (II) decrease of osteoclasts by bisphosphonates, (III) surgical treatment of damaged bone, (IV) irradiation to lytic bone lesion and (V) other forms of supportive care. All of these approaches should be effectively integrated to improve the quality of life of myeloma patients.