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Bisphosphonate therapy in multiple myeloma: past, present, future
Author(s) -
Jantunen Esa
Publication year - 2002
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1034/j.1600-0609.2002.02796.x
Subject(s) - medicine , multiple myeloma , bisphosphonate , hypercalcaemia , zoledronic acid , bone disease , osteolysis , bone resorption , bone pain , radiation therapy , oncology , bone density conservation agents , osteoporosis , intensive care medicine , surgery , bone density , calcium
Bone disease characterised by osteolytic lesions, pathological fractures and hypercalcaemia is an important clinical feature in multiple myeloma. Pain, decreased performance status, and the need for palliative radiotherapy and surgical interventions are common sequelae. Bisphosphonates act primarily on osteoclasts to inhibit excessive bone resorption, and have therefore been investigated in myeloma patients to ameliorate the clinical consequences of the bone disease. Bisphosphonates are currently the therapy of choice in myeloma patients with hypercalcaemia. In long‐term management, both oral clodronate and intravenous pamidronate are effective in reducing skeletal‐related events. Zoledronic acid seems to be as effective as pamidronate. Whether bisphosphonates have antimyeloma activity is currently unknown. Cost–benefit analyses have shown reasonable efficacy with acceptable costs. Bisphosphonate therapy is now accepted as an important part of care in myeloma patients, although much still has to be learned in order to optimise this therapy in multiple myeloma.