[Osteonecrosis of the jaw associated with the use of bisphosphonates in multiple myeloma: report of four cases and literature review].
OBJECTIVE
To summarize the clinical features of osteonecrosis of the jaw (ONJ) in multiple myeloma (MM) patients treated with bisphosphonate.


METHODS
The clinical data of 4 patients with bisphosphonate-related (ONJ) in MM were reported and literatures were reviewed.


RESULTS
In these patients, 3 males and 1 female, aged 59-73, pamidronate combined with chemotherapy, high dose glucocorticosteroid, and anti-angiogenic drug had been used for 12-44 months before the occurrence of ONJ. In treatment of ONJ conservative debridement of necrotic bone, systematic use of antibiotics, use of chlorhexidine acetate gargle, and withdrawal of bisphosphonates were preferable to aggressive surgical measures.


CONCLUSIONS
Long-term use of bisphosphonates combined with chemotherapy in MM may cause ONJ that involves both mandible and maxilla. No satisfactory therapy is currently available.
Li
Li-hong
LH
Department of Hematology, Beijing Chaoyang Hospital, Capital University of Medical Science, Beijing 100020, China.
Wu
Xue-bin
XB
Chen
Wen-ming
WM
Chen
Jian-xin
JX
Wu
Yin
Y
Chen
Shi-lun
SL
D000368:Aged; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D010020:Osteonecrosis / Q000139:chemically induced*
D004164:Diphosphonates