A population based study of multiple myeloma patients with medication-related osteonecrosis of the jaw
Daiga Auzina1, Anda Slaidina, Marina Sevastjanova
1Faculty of medicine. University of Latvia, 4 Hipokrata Street, Riga, Latvia. daiga.auzina@aslimnica.lv.
Objective:
Medication-related osteonecrosis of the jaw (MRONJ) is a rare complication of antiresorptive or antiangiogenetic therapy that manifests as an exposed bone with clinical signs of infection, persisting for more than 8 weeks, without history of radiation therapy or metastases to the jaws. The aim of the study was to describe the incidence, risk factors, staging process and clinical course of MRONJ in patients with multiple myeloma (MM).
Materials And Methods:
We retrospectively analyzed all (126) newly diagnosed MM patients at Riga East Clinical University Hospital (Riga. Latvia) from June 2014 to June 2017.
Results:
Among 88 MM patients treated with bisphosphonates (BP), 6 (6.8%) patients developed MRONJ. All six patients received intravenous nitrogen-containing BPs. The average time until MRONJ manifestation was under two years. For our patients the severity of MRONJ was stage I in two, stage II in three, and stage III in one patient. Five patients had MRONJ of mandibula and one of maxilla. All patients with MRONJ had undergone a dental extraction or a trauma before the development of MRONJ.
Conclusion:
We found that MRONJ correlated with the patient's age. The average time until MRONJ manifestation in reserach group is 2 years. One of triggerring MRONJ factors are tooth extraction or trauma.
Insights
Medication-related osteonecrosis of the jaw (MRONJ) occurred in 6.8% of multiple myeloma patients treated with bisphosphonates. Dental trauma or extraction preceded MRONJ, which correlated with patient age.
Area of Science:
- Oral surgery
- Oncology
- Pharmacology
Background:
- Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication of antiresorptive and antiangiogenic therapies.
- It presents as exposed bone in the jaw, persisting over 8 weeks, without prior radiation or metastatic disease.
- Multiple myeloma (MM) patients often receive these therapies, increasing their risk.
Purpose of the Study:
- To determine the incidence of MRONJ in multiple myeloma patients.
- To identify risk factors, staging, and clinical course of MRONJ in this population.
Main Methods:
- Retrospective analysis of 126 newly diagnosed multiple myeloma patients.
- Focus on 88 patients treated with bisphosphonates (BP) from June 2014 to June 2017.
Main Results:
- Six out of 88 (6.8%) patients developed MRONJ.
- All MRONJ cases involved intravenous nitrogen-containing bisphosphonates, with an average onset time of under two years.
- Dental extraction or trauma preceded MRONJ in all affected patients. MRONJ stages were I (2), II (3), and III (1).
Conclusions:
- MRONJ incidence in MM patients treated with BP is 6.8%.
- Patient age and dental procedures (extraction, trauma) are significant risk factors.
- Early identification and management are crucial for this patient group.
