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Osteonecrosis- Platelet Rich Plasma?
If dexamethasone has caused the myeloma patient to develop osteonecrosis (ON), can platelet rich plasma heal their bone damage?
According to the video linked below, one of the causes of ON is steroid use aka dexamethasone. As fate would have it, I fit several of the risk factors for MM survivors to develop ON-
- male,
- younger age,
- cumulative dose of dexamethasone-
Keep in mind that my ON developed in both of my shoulders. All the same issues/causes, etc. but different joint. I undergo acupuncture which has modestly improved or reduced the pain. And no collapse.
As a long-term survivor of this side effect, I am on the lookout for therapies that might heal my ON. While platelet-rich plasma appears to be a relatively new therapy, I am writing about it on PBC because of the potential.
How Stem Cells Can Treat Avascular Necrosis
As I mentioned above, weekly acupuncture has helped me reduce the shoulder pain caused by ON. I do not want to undergo joint replacement. However, platelet-rich plasma has always seemed like a therapy with real potential.
Email me at David.PeopleBeatingCancer@gmail.com with questions about managing MM side effects like avascular necrosis aka osteonecrosis.
Good luck,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Incidence and Risk Factors of Osteonecrosis of Femoral Head in Multiple Myeloma Patients Undergoing Dexamethasone-Based Regimens
Conclusion
The overall incidence of ONFH in MM patients treated with dexamethasone-based regimens (DBRs) is 6.7%, and 4 risk factors are confirmed including male, younger age, cumulative dose of dexamethasone, and hyperlipidemia in our study.
Osteonecrosis of the femoral head: treatment before the collapse. Experience with decompression and biological therapy
Osteonecrosis is a disabling condition and one of the most frequent causes of hip arthroplasty in the young population. Early detection and treatment in stages prior to femoral head collapse are essential to prevent progression and conversion to total hip arthroplasty (THA).
The present study aims to demonstrate the results obtained in the treatment of patients with initial stages of ONFH, treated with a decompression system that associates biologic therapy (platelet-rich plasma and mesenchymal stem cells) (PERFUSE).
Retrospective unicentric study, in which all patients with ONFH treated with decompression of the necrotic area and biological therapy between May 2018 and May 2023, was collected. Demographic data of the patients (age and gender), risk factors for AVN, area of necrosis (Kerboul), ARCO classification, collapse rate, and conversion to THA were obtained.
Twenty-four patients with ONFH were treated using the PERFUSE system. The mean age was 47.67 years old, and the mean follow-up was 26.1 months. The mean improvement in the modified Harris Hip Score (mHHS) was 10.11 (from 70.79 to 80.56; p = 0.018).
Patients who developed femoral head collapse had worse mHHS scores. Six patients (25%) progressed to femoral head collapse, of which 2 (8.33%) were converted to total hip arthroplasty (THA).
The probability of collapse-free survival at 12 months was 90.9% (SD 6.2; 95%CI, 79.5%–100%), and at 18 months, it was 85.2% (SD 8.0; 95%CI, 70.9%–100%), and at 24 months, it was 65.7% (SD 11.7; 95%CI, 46.3%–93.2%).
Core decompression with bone aspirate marrow and platelet-rich plasma can enhance bone regeneration and delay femoral head collapse, especially when implemented in early-stage ONFH.
In this sense, combining both, core decompression with biological support can offer a promising approach for managing early-stage ONFH. Despite encouraging outcomes, further research is needed to optimize treatment protocols and evaluate long-term efficacy.”
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