Bisphosphonates associated osteonecrosis of the jaw: A long-term follow-up of a series of 35 cases observed by GISL and evaluation of its frequency over time

Aims of the study were long term follow-up (FU) of bisphosphonates- associated osteonecrosis of the jaw (ONJ) in 35 cases observed by Gruppo Italiano Studio Linfomi (GISL) between 2002 and 2005 and the evaluation of its frequency in multiple myeloma patients over time. We asked the centres to up-date cases with ONJ, and to report new cases of ONJ diagnosed between 2006 and 2008. After a median FU of 31 months, 19 patients are alive, 13 died, mainly from progression of the primary disease, and three patients are lost to follow-up. Treatment was mainly conservative, however, nine patients underwent surgery. Overall improvement was reported in 13 patients, 11 stabilized, and eight patients progressed. One patient relapsed after dental procedure. ONJ impacted quality of life, causing pain and interfering with the ability to eat. Although the frequency of ONJ in myeloma patients in the period 2006-2008 was slightly increased (3.6% vs. 1.9% in 2002-2005), we confirm the rarity of the complication.