The effect and the mechanism of bortezomib on bone disease in patients with multiple myeloma.

Objective To study whether bortezomib combined with dexamethasone can relieve bone pain of patients with multiple myeloma and to see whether bortezomib have effect on bone metabolism through determining the concentration of bone turnover marks.Methods 59 cases of patients with multiple myeloma treated with BD and 38 cases of patients treated with VADM were observed before and after chemotherapy to compare the alleviation of bone pain,the improvement of the ability to move and the occurrence of skeletal related events between the two groups.The plasma from 25 patients were collected before and after chemotherapy when they were in hospital each time and the concentrations of TRACP-5b,BALP and DKK1 in plasma were determined by ELISA.Results BD group was better than VADM group in the rate of alleviation of bone pain,the improvement of the ability to move and the incidence of skeletal related events(75.7% vs 50%,64.9% vs 20.8% and 13.8% vs 57.8%,all P0.05).The level of BALP increased and the level of TRACP-5b and DKK1 decreased after the treatment in BD group.Conclusion Bortezomib can relive the bone pain of patients with multiple myeloma,improve the ability to move and decrease the incidence of skeletal related events.Bortezomib can also promote the bone formation and inhibit the bone destruction.