Bisphosphonate therapy in multiple myeloma

Lytic bone lesions, pathological fractures, hypercalcaemia and osteoporosis are common features in patients with multiple myeloma. Adjunctive therapeutic modalities in addition to antimyeloma therapy have been sought to ameliorate these clinical consequences of bone disease. Bisphosphonates appear to be useful in this respect. In addition to correcting hypercalcaemia, they reduce the amount of new bone lesions and pathological fractures in myeloma patients. Bisphosphonates also relieve bone pain. In placebo-controlled studies clodronate (1600-2400 mg/d orally) and pamidronate (90 mg intravenously once every month) have produced clinically significant effects in myeloma patients. Bisphosphonates are a useful adjunct therapy in patients with multiple myeloma.