Evolution of bisphosphonate-related osteonecrosis of the jaw in patients with multiple myeloma and Waldenstrom's macroglobulinemia: A retrospective multicentric study

A. Andriani, M. T. Petrucci, T. Caravita, M. Montanaro, N. Villivà, A. Levi, A. Siniscalchi, V. Bongarzoni, F. Pisani, De M Muro, U. Coppetelli, G. Avvisati, A. Zullo, A. Agrillo, D. Gaglioti

Research output: Contribution to journalArticle

Abstract

Bisphosphonates (BPs) are used intravenously to treat cancer-related conditions for the prevention of pathological fractures. Osteonecrosis of the jaw (BRONJ) is a rare complication reported in 4-15% of patients. We studied, retrospectively, 55 patients with multiple myeloma or Waldenstrom's macroglobulinemia followed up from different haematological departments who developed BRONJ. All patients were treated with BPs for bone lesions and/or fractures. The most common trigger for BRONJ was dental alveolar surgery. After a median observation of 26 months, no death caused by BRONJ complication was reported. In all, 51 patients were treated with antibiotic therapy, and in 6 patients, this was performed in association with surgical debridement of necrotic bone, in 16 with hyperbaric O 2 therapy/ozonotherapy and curettage and in 12 with sequestrectomy and O 2/hyperbaric therapy. Complete response was observed in 20 cases, partial response in 21, unchanged in 9 and worsening in 3. The association of surgical treatment with antibiotic therapy seems to be more effective in eradicating the necrotic bone than antibiotic treatment alone. O 2 hyperbaric/ozonotherapy is a very effective treatment. The cumulative dosage of BPs is important for the evolution of BRONJ. Because the most common trigger for BRONJ was dental extractions, all patients, before BP treatment, must achieve an optimal periodontal health.

Original languageEnglish
Article numbere62
JournalBlood Cancer Journal
Volume2
Issue number3
DOIs
Publication statusPublished - Apr 2012

Keywords

  • Bisphosphonate
  • Multiple myeloma
  • Osteonecrosis
  • Pamidronate
  • Zolendronate

ASJC Scopus subject areas

  • Oncology
  • Hematology

Fingerprint Dive into the research topics of 'Evolution of bisphosphonate-related osteonecrosis of the jaw in patients with multiple myeloma and Waldenstrom's macroglobulinemia: A retrospective multicentric study'. Together they form a unique fingerprint.

  • Cite this

    Andriani, A., Petrucci, M. T., Caravita, T., Montanaro, M., Villivà, N., Levi, A., Siniscalchi, A., Bongarzoni, V., Pisani, F., M Muro, D., Coppetelli, U., Avvisati, G., Zullo, A., Agrillo, A., & Gaglioti, D. (2012). Evolution of bisphosphonate-related osteonecrosis of the jaw in patients with multiple myeloma and Waldenstrom's macroglobulinemia: A retrospective multicentric study. Blood Cancer Journal, 2(3), [e62]. https://doi.org/10.1038/bcj.2012.9