Anne-Marie Heegaard

Abstract

Pain in Multiple Myeloma – interaction of the cancer microenvironment with the sensory nervous system.

Multiple myeloma is a hematologic malignancy and at the time of diagnosis more than half the patients with multiple myeloma suffer from bone pain, which is often severe. We have identified bone marrow denervation and periosteal nerve sprouting (calcitonin gene-related peptide and growth associated protein 43 positive fibers) in a mouse model of multiple myeloma-induced bone pain and we have provided human data supporting these findings.

Furthermore, in the mouse model, gene expression changes were found in the dorsal root ganglia innervating the myeloma-bearing bone suggested alterations in pathways associated with cell cycle, immune response and neuronal signaling. Overall, our results suggest that multiple myeloma induces a range of peripheral nervous system alterations that may contribute to bone pain.