Oncology Medical News about osteonecrosis of the jaw; multiple myeloma

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Natural history of osteonecrosis of the jaw in patients with multiple myeloma
Journal of Clinical Oncology, 12/24/08

Badros A et al. - In a study to evaluate the natural history of bisphosphonate-related osteonecrosis of the jaw (ONJ) in pts with multiple myeloma, it was found that ONJ healed in 75% of pts. Patients with spontaneous ONJ have a higher risk of nonhealing and recurrence. Reinitiating bisphosphonates after healing of ONJ is a reasonable option in pts experiencing relapse who are at risk of skeletal complications.

Methods

97 pts with myeloma from the US (n = 37) and Greece (n = 60) were observed prospectively for a minimum 3.2 yrs after ONJ.
Pts' characteristics were similar with regard to age, bisphosphonate use, and myeloma therapy, except more autologous transplantations were performed on pts in the US than in Greece.

Results

ONJ resolved in 60 pts, resolved and recurred in 12 pts, and did not heal in 25 pts.
Dental procedures preceded ONJ in 46 pts and were more common in those with single episodes (35 of 60) than recurrent or nonhealing (11 of 37).
Recurrent ONJ followed reinitiation of bisphosphonates in 6 of 12 pts.
Greek pts had more bone pain than US pts (60% v 30%) and were less likely to restart bisphosphonates (5% v 35%).
Myeloma relapses were more common in pts with recurrent/nonhealing than single-episode ONJ (84% v 62%).
Median overall survival from myeloma diagnosis was 10.8 yrs and did not differ between pts with single, recurrent, and nonhealing ONJ.

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