The use of biochemical markers of bone remodeling in multiple myeloma: A report of the International Myeloma Working Group: A report of the International Myeloma Working Group

E. Terpos, M.A. Dimopoulos, O. Sezer, D. Roodman, N. Abildgaard, R. Vescio, P. Tosi, R. Garcia-Sanz, F. Davies, A. Chanan-Khan, A. Palumbo, P. Sonneveld, M.T. Drake, J.-L. Harousseau, K.C. Anderson, B.G.M. Durie, Dina Ben-Yehuda-Salz

Research output: Contribution to journalArticlepeer-review

74 Scopus citations


Lytic bone disease is a frequent complication of multiple myeloma (MM). Lytic lesions rarely heal and X-rays are of limited value in monitoring bone destruction during anti-myeloma or anti-resorptive treatment. Biochemical markers of bone resorption (amino- and carboxy-terminal cross-linking telopeptide of type I collagen (NTX and CTX, respectively) or CTX generated by matrix metalloproteinases (ICTP)) and bone formation provide information on bone dynamics and reflect disease activity in bone. These markers have been investigated as tools for evaluating the extent of bone disease, risk of skeletal morbidity and response to anti-resorptive treatment in MM. Urinary NTX, serum CTX and serum ICTP are elevated in myeloma patients with osteolytic lesions and correlate with advanced disease stage. Furthermore, urinary NTX and serum ICTP correlate with risk for skeletal complications, disease progression and overall survival. Bone markers have also been used for the early diagnosis of bone lesions. This International Myeloma Working Group report summarizes the existing data for the role of bone markers in assessing the extent of MM bone disease and in monitoring bone turnover during anti-myeloma therapies and provides information on novel markers that may be of particular interest in the near future. © 2010 Macmillan Publishers Limited All rights reserved.
Original languageEnglish
Pages (from-to)1700-1712
Number of pages13
Issue number10
StatePublished - 2010

Bibliographical note

Cited By :72

Export Date: 3 October 2022


Correspondence Address: Terpos, E.; Department of Clinical Therapeutics, 80 Vas. Sofias Avenue, Athens 11528, Greece; email:

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  • bone markers
  • CTX
  • ICTP
  • myeloma
  • NTX
  • amino terminal telopeptide
  • biochemical marker
  • carboxy terminal telopeptide
  • matrix metalloproteinase
  • bone atrophy
  • bone destruction
  • bone disease
  • bone remodeling
  • bone turnover
  • disease activity
  • disease course
  • early diagnosis
  • human
  • morbidity
  • multiple myeloma
  • ossification
  • osteolysis
  • overall survival
  • priority journal
  • review


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