Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Osteoporotic vertebral compression fracture (VCF) is a frequently encountered clinical problem associated with chronic pain and disability. Conservative treatment in the form of bed rest, pain control and bracing may create a vicious circle, in which reduced activity leads to further reduction in bone density and fracture risk. Percutaneous vertebroplasty (PVP) is an accepted treatment modality for osteoporotic vertebral body collapse present for less than 1 year, vertebral myeloma, haemangioma, metastasis and recent traumatic fractures (between 3 and 12 months). We describe an osteoporotic patient in whom successful PVP was performed, under general anaesthesia using CT and fluoroscopic guidance, in a post-traumatic 5-year-old VCF with complete alleviation of debilitating pain. In the light of our experience, we suggest that PVP should be carried out in a series of similar patients to asses its value as a treatment option in patients with chronic osteoporotic vertebral fractures for pain relief and improvement in mobility, independent of fracture age.
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PMID:Successful treatment of a chronic post-traumatic 5-year-old osteoporotic vertebral compression fracture by percutaneous vertebroplasty. 1573 Sep 94

Inspite the new informations about the physiology and biochemistry of pain, it remains true that pain is only partially understood. Cancer pain is often experienced as several different types of pain, with combined somatic and neuropathic types the most frequently. If the acute cancer pain does not subside with initial therapy, patients experience pain of more constant nature, the characteristics of wich vary with the cause and the involved sites. Chronic pain related to cancer can be considered as tumor-induced pain, chemotherapy-induced pain, and radiation therapy-induced pain. Certain pain mechanisms are present in cancer patients. These include inflammation due to infection, such as local sepsis or the pain of herpes zoster, and pain due to the obstruction or occlusion of a hollow organ, such as that caused by large bowel in cancer of colon. Pain also is commonly due to destruction of tissue, such as is often seen with bony metastases. Bony metastases also produce pain because of periostal irritation, medullary pressure, and fractures. Pain may be produced by the growth of tumor in a closed area richly supplied with pain receptors (nociceptors). Examples are tumors growing within the capsule of an organ such as the pancreas. Chest pain occurring after tumor of the lung or the mediastinum due to invasion of the pleura. Certain tumors produce characteristic types of pain. For example, back pain is seen with multiple myeloma, and severe shoulder pain and arm pain is seen with Pancoast tumors.
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PMID:Cancer pain (classification and pain syndromes). 1601 3

Percutaneous vertebroplasty has been used to treat aggressive vertebral hem-angiomas, osteoporotic vertebral compression fractures, and vertebral lesions from metastatic disease or myeloma. Consider it for patients with severe acute or chronic pain related to one of these lesions who have failed a reasonable course of medical therapy (strength of recommendation [SOR]: B, based on structured reviews of observational studies). Contraindications include an uncorrectable coagulation disorder, infection in the area, spinal cord compression, destruction of the posterior wall of the vertebral body, and severe degrees of vertebral body collapse (SOR: B, based on structured reviews of observational studies). Pain relief from vertebroplasty for osteoporotic vertebral fractures may be less for older fractures (SOR: C).
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PMID:Clinical inquiries. Who should receive vertebroplasty? 1682 55

The combination acetominophen/tramadol implies the use of two molecules which are different in the pharmacological structure but share a biological similarity in kinetics. Their respective actions are directed to different components of the nociceptive afference. Hematological clinical practice daily challenges diseases in with pain may be a very important symptom, ranging from acute leukemia to the common effects of certain chemotherapy regimens. Multiple myeloma gives one of the best example of a disease in which pain can be inflammatory (the compression of a nerve root) or neuropathic (demyelinating process) in origin. The use of acetaminophen/tramadol combination in the common ward or outward activity with myeloma patients indicates how it is possible to reach a good control of chronic pain with a minimum overlapping of the toxicities related to the primary disease as well as to the specific treatment. Furthermore, acetaminophen/tramadol combination is extremely useful also in those clinical situations in which a short term pain control is needed, particularly for the optimal safety profile.
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PMID:[The combination acetominophen/tramadol in hematological daily practice]. 1903 60

Pain is a troublesome problem in multiple myeloma (MM) patients which may be affected by several pain syndromes sustained by different underlying causes and mechanisms- In this setting may be due to the disease itself, to its complications, to diagnostic procedures and therapeutic interventions. Most pain syndromes origin from the skeleton and are related to several aspects of the myeloma bone disease (osteolysis and osteopenia). Other remarkable pains frequently observed in MM are due to disease-related and iatrogenic neuropathies. For most MM patients the World Health Organization's three-step analgesic ladder can be effective, although difficult-to-treat pain conditions are frequently observed, given the occurrence of some prognostically negative features, such as the mechanical instability and some neuropathic conditions. Therefore, the management of pain in this setting should require a multidisciplinary approach and the application of causal interventions (chemotherapy and radiotherapy) and of other pain-relieving procedural measures (i.e. vertebroplasty and orthopedic surgery). A prompt treatment of pain is necessary in order to avoid potentially devastating consequence, such the occurrence of chronic pain syndromes which may be due to central sensitization.
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PMID:[Physiopathology and management of pain in multiple myeloma]. 2119 2

Parathyroid hormone-related peptide (PTHrP) is associated with advanced tumor growth and metastasis, especially in breast, prostate and myeloma cancers that metastasize to bones, resulting in debilitating chronic pain conditions. Our recent studies revealed that the receptor for PTHrP, PTH1R, is expressed in mouse DRG sensory neurons, and its activation leads to flow-activation and modulation of TRPV1 channel function, resulting in peripheral heat and mechanical hypersensitivity. In order to verify the translatability of our findings in rodents to humans, we explored whether this signalling axis operates in primary human DRG sensory neurons. Analysis of gene expression data from recently reported RNA deep sequencing experiments performed on mouse and human DRGs reveals that PTH1R is expressed in DRG and tibial nerve. Furthermore, exposure of cultured human DRG neurons to PTHrP leads to slow-sustained activation of TRPV1 and modulation of capsaicin-induced channel activation. Both activation and modulation of TRPV1 by PTHrP were dependent on PKC activity. Our findings suggest that functional PTHrP/PTH1R-TRPV1 signalling exists in human DRG neurons, which could contribute to local nociceptor excitation in the vicinity of metastatic bone tumor microenvironment.
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PMID:Parathyroid hormone-related peptide activates and modulates TRPV1 channel in human DRG neurons. 2979 79

Most patients with multiple myeloma (MM) suffer from chronic pain at every stage of the natural disease process. This review focuses on the most common causes of chronic pain in MM patients: (1) pain from myeloma bone disease (MBD); (2) chemotherapy-induced peripheral neuropathy as a possible consequence of proteasome inhibitor therapy (i.e., bortezomib-induced); (3) post-herpetic neuralgia as a possible complication of varicella zoster virus reactivation because of post-transplantation immunodepression; and (4) pain in cancer survivors, with increasing numbers due to the success of antiblastic treatments, which have significantly improved overall survival and quality of life. In this review, non-pain specialists will find an overview including a detailed description of physiopathological mechanisms underlying central sensitization and pain chronification in bone pain, the rationale for the correct use of analgesics and invasive techniques in different pain syndromes, and the most recent recommendations published on these topics. The ultimate target of this review was to underlie that different types of pain can be observed in MM patients, and highlight that only after an accurate pain assessment, clinical examination, and pain classification, can pain be safely and effectively addressed by selecting the right analgesic option for the right patient.
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PMID:Pain Management in Patients with Multiple Myeloma: An Update. 3186 Oct 97