[Bisphosphonates in the treatment of multiple myeloma]

Bisphosphonates are the most potent class of antiresorpitve drugs used in the treatment of bone diseases with enhanced resorption, like malignant osteolysis, osteoporosis and Paget's disease. Multiple myeloma is commonly associated with skeletal morbidity, including osteolysis, bone fractures, pain and hypercalcemia. These clinical complications result from increased osteoclast number and function which is due to release of osteoclast-stimulating factors by myeloma cells and the tumoral environment. By inhibition of osteoclast activity and inducing cell apoptosis, bisphosphonates can prevent development of bone destruction in myeloma patients. This article reviews efficacy of bisphosphonates in reducing skeletal events in patients with multiple myeloma and several in vitro studies which have shown that aminobisphosphonates may act as antimyeloma agents.