title: Bisphosphonate-associated osteonecrosis of the jaw: a review of 35 cases and an evaluation of its frequency in multiple myeloma patients.
abstract: Over a period of 28 months, we observed five cases of osteonecrosis of the jaw (ONJ) in cancer patients treated with bisphosphonates (BP) at our institution. This prompted us to undertake a retrospective, multicenter study to analyse the characteristics of patients who exhibited ONJ and to define the frequency of ONJ in multiple myeloma (MM). We identified 35 cases in Gruppo Italiano Studio Linfomi centers during the period 2002 - 05. The median time from cancer diagnosis to the clinical onset of ONJ was 70 months. In these 35 cases of ONJ, 24 appeared 20 - 60 months after starting BP treatment. The time for the onset of ONJ was significantly shorter for patients treated with zoledronic acid alone than for those treated with pamidronate followed by zoledronic acid. The frequency of ONJ in the MM group during the study period was 1.9%, although the nature of the present study may have resulted in an underestimation of ONJ cases. Our analysis strongly suggested an association between the use of BP and the occurrence of ONJ, although we were unable to identify any definite risk factors with a retrospective study. The most frequently ONJ-associated clinical characteristics were chemotherapy treatment, steroid treatment, advanced age, female sex, anemia, parodonthopaties/dental procedures and thalidomide (in the case of MM patients).
authors.affiliation: Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Samantha
authors.initials: S
authors.lastname: Pozzi
authors.forename: Raffaella
authors.initials: R
authors.lastname: Marcheselli
authors.forename: Stefano
authors.initials: S
authors.lastname: Sacchi
authors.forename: Luca
authors.initials: L
authors.lastname: Baldini
authors.forename: Francesco
authors.initials: F
authors.lastname: Angrilli
authors.forename: Elsa
authors.initials: E
authors.lastname: Pennese
authors.forename: Giovanni
authors.initials: G
authors.lastname: Quarta
authors.forename: Caterina
authors.initials: C
authors.lastname: Stelitano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Caparotti
authors.forename: Stefano
authors.initials: S
authors.lastname: Luminari
authors.forename: Pellegrino
authors.initials: P
authors.lastname: Musto
authors.forename: Donato
authors.initials: D
authors.lastname: Natale
authors.forename: Chiara
authors.initials: C
authors.lastname: Broglia
authors.forename: Angela
authors.initials: A
authors.lastname: Cuoghi
authors.forename: Daniele
authors.initials: D
authors.lastname: Dini
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Tonno
authors.forename: Giovanna
authors.initials: G
authors.lastname: Leonardi
authors.forename: Graziano
authors.initials: G
authors.lastname: Pianezze
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pitini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Polimeno
authors.forename: Luisa
authors.initials: L
authors.lastname: Ponchio
authors.forename: Luciano
authors.initials: L
authors.lastname: Masini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Musso
authors.forename: Mauro
authors.initials: M
authors.lastname: Spriano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pollastri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015994:Incidence; D007571:Jaw Diseases / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009101:Multiple Myeloma / Q000188:drug therapy*; D010020:Osteonecrosis / Q000139:chemically induced* / Q000453:epidemiology; D012189:Retrospective Studies
chemical_list: D004164:Diphosphonates