title: Jaw osteonecrosis associated with use of bisphosphonates and chemotherapy: paradoxical complication of treatment of bone lesions in multiple myeloma patients.
abstract: It has been demonstrated that bisphosphonate-based supportive therapy (pamidronate or zoledronate) reduces skeletal events (onset or progression of osteolytic lesions) both in patients with multiple myeloma (MM) and in cancer patients with bone metastasis. Bisphosphonates (eg, alendronate) are also indicated in the treatment of osteoporosis. Nevertheless, osteonecrosis of the jaw (ONJ) has been reported in some patients being treated with bisphosphonates. We present a series of 9 MM patients who developed ONJ after treatment with bisphosphonates and chemotherapy. All the patients in this case series had undergone tooth extraction for recurrent dental abscesses while taking bisphosphonates. We also review the diagnostic and therapeutic implications of this paradoxical complication associated with treatment of bone lesions in MM.
authors.affiliation: Hematology Section, Department of Internal Medicine and Public Medicine, University of Bari Policlinico, Bari, Italy. sf.capalbo@ematba.uniba.it
authors.forename: Silvana
authors.initials: S
authors.lastname: Capalbo
authors.forename: Mario
authors.initials: M
authors.lastname: Delia
authors.forename: Daniela
authors.initials: D
authors.lastname: Diomede
authors.forename: Michelina
authors.initials: M
authors.lastname: Dargenio
authors.forename: Antonia
authors.initials: A
authors.lastname: Chiefa
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Favia
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Liso
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000556:secondary; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007568:Jaw / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D010020:Osteonecrosis / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology / Q000628:therapy
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates