Premium
First‐line therapy with thalidomide, dexamethasone and zoledronic acid decreases bone resorption markers in patients with multiple myeloma
Author(s) -
Tosi Patrizia,
Zamagni Elena,
Cellini Claudia,
Parente Raffaele,
Cangini Delia,
Tacchetti Paola,
Perrone Giulia,
Ceccolini Michela,
Boni Paola,
Tura Sante,
Baccarani Michele,
Cavo Michele
Publication year - 2006
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 - 10.1111/j.0902-4441.2005.t01-1-ejh2520.x
Subject(s) - thalidomide , zoledronic acid , multiple myeloma , dexamethasone , medicine , bone resorption , bone density conservation agents , oncology , cancer research , osteoporosis , bone density
Background : Bone involvement is frequently observed in multiple myeloma (MM) patients both at diagnosis and during the course of the disease. The evaluation of biochemical markers of bone turnover could allow a dynamic evaluation of the effects of a given therapy on bone metabolism. Methods : In the present study, markers of bone resorption [urinary free pyridinoline (PYD), deoxypyridinoline (DPYD), N‐terminal telopeptide of collagen I (NTX) and C‐terminal telopeptide (serum crosslaps)] and of bone formation [bone alkaline phosphatase (BAP) and osteocalcin] were evaluated at diagnosis and after induction therapy in 40 patients (23M, 17F, median age = 53.5 yr) enrolled in the ‘Bologna 2002’ clinical trial. By study design, all patients received 4 months of combined thalidomide (100 mg/d for 2 wk then 200 mg/d), dexamethasone (40 mg/d on days 1–4, 9–12, 17–20/28 on odd cycles and on days 1–4 on even cycles) and zoledronic acid (4 mg/28 d). Results : At diagnosis, although bone resorption markers were increased in more than 40% of the patients, only NTX ( P = 0.029) and crosslaps ( P = 0.000) were significantly related to the extent of skeletal lesions, as assessed by X‐ray. After 4 months of therapy, a significant decrease in mean (±SE) urinary NTX (52.7 ±6.9 nmol/mmol creatinine ±6.9 vs. 14 ± 1.42 nmol/mmol creatinine, P = 0.000) and serum crosslaps (6242.4 ±945 pmol/L vs. 1414.9 ± 173.8 pmol/L, P = 0.000) was observed in patients obtaining ≥partial response, at variance to what has been detected in patients showing