[Bone manifestations of multiple myeloma and therapeutic possibilities]

In the text are summarized the results of studies dealing with supportive therapy of multiple myeloma bone disease. The similarities of primary osteoporosis and osteoporosis in multiple myeloma raised a hope that sodium fluoride will help to prevent or to slow down the osteoporotic process in multiple myeloma patients. The first studies in small groups of patients reported some advantage for the patients with sodium fluoride, later in randomized studies no benefit of sodium fluoride was confirmed. The effect of calcitonin was studied in small groups of patients. All studies confirmed analgetic effect and some of them proved positive effect on the amount of bone hydroxyapatite by a histomorphometric examination. The contribution of bisphosphonate to the therapy of myeloma patients was confirmed in extensive studies. With the exception of a Canadian study with ethidronate, all studies reported good analgetic effects and the inhibitory influence on bone destruction. The advantage of bisphosphonates in comparison to calcitonin is the possibility of p.o. administration or in i.v. periodical administration several times a year.