Do certain types of myeloma affect your bones more than others?

Do myeloma cells directly cause bone damage? So I think it's important to recognize that myeloma cells themselves don't actually cause any bone damage. What they do is they interact with the bone cells that are there, which are the osteoclasts, which are the cells that scoop out the bone, and the osteoblasts, which are the cells that fill in the bone. And by doing so, the myeloma cells basically cause bone to be damaged. Albeit indirectly through the bone cells themselves. And then, so there are signals that the myeloma cells send to the bone cells that lead to higher bone resorption, or bone being scooped out. And then, while simultaneously, they suppress the bone from actually being formed. So usually, if one doesn't have multiple myeloma and the osteoclast scoops out bone, then what would happen would be the osteoclast would say, oh boy, there's been some bone that's been scooped out. I'm going to try to fill in that hole and try to fix that. What happens in myeloma is that the bone gets scooped out, but then the osteoblast, instead of getting a signal that should actually try to fill that in, actually doesn't get that signal in so that there's a mismatch. As the bone is being scooped out, there are a lot of growth factors embedded in the bone, and those growth factors get released. And then that can lead to basically factors that then can stimulate the myeloma cells to grow. And so we call that basically a vicious cycle. Myeloma cells, factors that affect the bone, and then bone has factors that basically get released that basically then fuel a myeloma. When you have myeloma bone destruction, potentially augmenting the activity of your myeloma cells, that's the type of information available in a research setting, in a laboratory setting. But when I'm dealing with patients, I don't have access to is their myeloma bone disease potentially augmenting their myeloma. All we know is, is their myeloma in control or not, and what do we do to cool it down? Genetically, there are, by gene expression profiling studies performed first at University of Arkansas, they looked and found certain subtypes more likely to be associated with myeloma bone disease, but it's not black and white. It's just showed that there's were more likely, some forms were more likely and some forms were less likely in your average clinical context, where we don't have access to those research studies, it doesn't really play in the clinical decisions.