The bone disease seen in multiple myeloma is described as se

The bone disease seen in multiple myeloma is described as: (select all correct responses)

a. hyperactive osteoblasts

b. hyperactive osteoclasts

c. suppression of osteoblastic activity

d. lack of osteogenic cytokines

Explanation appreciated.

Solution

b. hyperactive osteoclasts.

c. suppression of osteoblastic activity.

Multiple myeloma bone diseases is due to the overexpression of receptor activator for nuclear factor B ligand (RANKL) by bone marrow stroma. RANKL activates osteoclasts, which resorb bone. Suppression of osteoblast activity plays a key role in the bone destructive process as well as progression of the tumor burden in myeloma.