The Role of Bisphosphonates in Multiple Myeloma
Authors: Robert A. Kyle
Journal: Annals of Internal Medicine (2000)

Editorials2 May 2000The Role of Bisphosphonates in Multiple MyelomaRobert A. Kyle, MDRobert A. Kyle, MDMayo Clinic and Mayo Foundation; Rochester, MN 55905 (Kyle)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-9-200005020-00009 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Multiple myeloma is characterized by bone destruction that often leads to some of the most debilitating manifestations of this disease: pain, hypercalcemia, osteopenia, pathologic fractures, and spinal cord compression. These clinical manifestations are due not only to myeloma deposits in the bone, which lead to focal bone destruction, but also to increased osteoporotic activity, resulting in bone resorption. Chemotherapy, even when successful, does not produce skeletal healing, and the dual risks of osteopenia and pathologic fracture persist. Fortunately, this often grim situation has at last begun to yield to pharmacologic intervention since the administration of bisphosphonates has been found to ...References1. Coukell AJ, Markham A. Pamidronate. A review of its use in the management of osteolytic bone metastases, tumour-induced hypercalcaemia and Paget's disease of bone. Drugs Aging. 1998;12:149-68. CrossrefMedlineGoogle Scholar2. Berenson JR, Lipton A. Bisphosphonates in the treatment of malignant bone disease. Annu Rev Med. 1999;50:237-48. CrossrefMedlineGoogle Scholar3. de Groen PC, Lubbe DF, Hirsch LJ, Daifotis A, Stephenson W, Freedholm D, et al . Esophagitis associated with the use of alendronate. N Engl J Med. 1996;335:1016-21. CrossrefMedlineGoogle Scholar4. Belch AR, Bergsagel DE, Wilson K, O'Reilly S, Wilson J, Sutton D, et al . Effect of daily etidronate on the osteolysis of multiple myeloma. J Clin Oncol. 1991;9:1397-402. CrossrefMedlineGoogle Scholar5. Merlini G, Parrinello GA, Piccinini L, Crema F, Fiorentini ML, Riccardi A, et al . Long-term effects of parenteral dichloromethylene bisphosphonate (CL2MBP) on bone disease of myeloma patients treated with chemotherapy. Hematol Oncol. 1990;8:23-30. CrossrefMedlineGoogle Scholar6. Lahtinen R, Laakso M, Palva I, Virkkunen P, Elomaa I. Randomised, placebo-controlled multicentre trial of clodronate in multiple myeloma. Finnish Leukaemia Group. Lancet. 1992;340:1049-52. CrossrefMedlineGoogle Scholar7. McCloskey EV, MacLennan IC, Drayson MT, Chapman C, Dunn J, Kanis JA. A randomized trial of the effect of clodronate on skeletal morbidity in multiple myeloma. MRC Working Party on Leukaemia in Adults. Br J Haematol. 1998;100:317-25. CrossrefMedlineGoogle Scholar8. Berenson JR, Rosen L, Vescio R, Lau HS, Woo M, Sioufi A, et al . Pharmacokinetics of pamidronate disodium in patients with cancer with normal or impaired renal function. J Clin Pharmacol. 1997;37:285-90. CrossrefMedlineGoogle Scholar9. Berenson JR, Lichtenstein A, Porter L, Dimopoulos MA, Bordoni R, George S, et al . Efficacy of pamidronate in reducing skeletal events in patients with advanced multiple myeloma. Myeloma Aredia Study Group. N Engl J Med. 1996;334:488-93. CrossrefMedlineGoogle Scholar10. Berenson JR, Lichtenstein A, Porter L, Dimopoulos MA, Bordoni R, George S, et al . Long-term pamidronate treatment of advanced multiple myeloma patients reduces skeletal events. Myeloma Aredia Study Group. J Clin Oncol. 1998;16:593-602. CrossrefMedlineGoogle Scholar11. Brincker H, Westin J, Abildgaard N, Gimsing P, Turesson I, Hedenus M, et al . Failure of oral pamidronate to reduce skeletal morbidity in multiple myeloma: a double-blind placebo-controlled trial. Danish-Swedish Co-operative Study Group. Br J Haematol. 1998;101:280-6. CrossrefMedlineGoogle Scholar12. Abildgaard N, Rungby J, Glerup H, Brixen K, Kassem M, Brincker H, et al . Long-term oral pamidronate treatment inhibits osteoclastic bone resorption and bone turnover without affecting osteoblastic function in multiple myeloma. Eur J Haematol. 1998;61:128-34. CrossrefMedlineGoogle Scholar13. Fontana A, Herrmann Z, Menssen HD, Sakalova A, Boewer C, Facon T, et al . Effects of intravenous ibandronate therapy on skeletal related events (SRE) and survival in patients with advanced multiple myeloma [Abstract]. Blood. 1998;92 Suppl 1 106a. Google Scholar14. Shipman CM, Rogers MJ, Apperley JF, Russell RG, Croucher PI. Bisphosphonates induce apoptosis in human myeloma cell lines: a novel anti-tumour activity. Br J Haematol. 1997;98:665-72. CrossrefMedlineGoogle Scholar15. Shipman CM, Croucher PI, Russell RG, Helfrich MH, Rogers MJ. The bisphosphonate incadronate (YM175) causes apoptosis of human myeloma cells in vitro by inhibiting the mevalonate pathway. Cancer Res. 1998;58:5294-7. MedlineGoogle Scholar16. Sjak-Shie NN, Tsingotjidou AS, Zhang K, Vescio RA, Said JW, Lieberman J, et al . Development of a SCID-hu animal model that more closely resembles human multiple myeloma [Abstract]. Blood. 1999;94 Suppl 1 547a. Google Scholar17. Yaccoby S, Barlogie B, Epstein J. Pamidronate inhibits growth of myeloma in vivo in the SCID-hu system [Abstract]. Blood. 1998;92 Suppl 1 106a. Google Scholar18. Dhodapkar MV, Singh J, Mehta J, Fassas A, Desikan KR, Perlman M, et al . Anti-myeloma activity of pamidronate in vivo. Br J Haematol. 1998;103:530-2. CrossrefMedlineGoogle Scholar19. Mundy G, Garrett R, Harris S, Chan J, Chen D, Rossini G, et al . Stimulation of bone formation in vitro and in rodents by statins. Science. 1999;286:1946-9. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Robert A. Kyle, MDAffiliations: Mayo Clinic and Mayo Foundation; Rochester, MN 55905 (Kyle)Disclaimer: This editorial does not imply that Mayo Foundation endorses any of the products mentioned therein.Disclosure: Dr. Kyle is on the Speaker's Bureau of OrthoBiotech, Schering-Plough, and Novartis. He also serves as a consultant to Hoffman-LaRoche.Grant Support: In part by National Cancer Institute grant CA62242.Corresponding Author: Robert A. Kyle, MD, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byImproved survival in multiple myeloma, with a diminishing racial gap and a widening socioeconomic status gap over three decadesThe Role of Bisphosphonates in Medical Oncology and Their Association with Jaw Bone NecrosisMultiple MyelomaEvaluation of the Patient at Risk for OsteoporosisAlendronate Affects Cartilage Resorption by Regulating Vascular Endothelial Growth Factor Expression in RatsZoledronate, Smoking, and Obesity Are Strong Risk Factors for Osteonecrosis of the Jaw: A Case-Control StudySevere Spontaneous Cases of Bisphosphonate-Related Osteonecrosis of the JawsBisphosphonate treatment: An orthodontic concern calling for a proactive approachFragile Bones in a Young MaleFracture Risk in Monoclonal Gammopathy of Undetermined SignificanceAdvances in the Treatment of Bone MetastasesUse of Bisphosphonates in Patients With Myeloma and Renal FailureUse of Bisphosphonates in Patients With Myeloma and Renal Failure–Reply–IMagnetic resonance imaging as a supplement for the clinical staging system of Durie and Salmon?Current Therapy for Multiple MyelomaRole of bisphosphonates in the nonoperative treatment of patients with bone tumorsThalidomide in the treatment of multiple myelomaUpdate on the Treatment of Multiple Myeloma 2 May 2000Volume 132, Issue 9Page: 734-736KeywordsBoneBone remodelingBone resorptionHypercalcemiaLesionsMultiple myelomaMyelomaOral administrationOsteopeniaSpinal cord ePublished: 15 August 2000 Issue Published: 2 May 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...