title: [Regression of an osteolytic lesion in a patient with multiple myeloma treated with clodronate after a successful therapy with bortezomib-based regimen].
abstract: BACKGROUND
  Osteolytic lesions are a common manifestation of multiple myeloma, though their healing is rare in these patients. Generally, during a complete remission, lesions only stop progressing; radiologically evident recalcification is exceptional.
  
  
  METHODS
  Herein we report a case of a male patient born in 1941 and diagnosed in 2005 with IgA multiple myeloma presenting with multiple osteolytic bone lesions. Administration of 4 cycles of VAD chemotherapy (vincristine, adriamycin, dexamethasone) with subsequent autologous peripheral blood stem cell transplantation and maintenance treatment with interferon alpha had resulted into a very good partial remission. In 2009, the disease relapsed with enlargement of osteolytic lesions evident on skiagrams. The largest lesion, reaching 24 x 10 mm in size, was located in the left femur. A complete remission of the disease was achieved with CVD senior regimen (cyclophosphamide, bortezomib, dexamethasone, 8 cycles in total). Bisphosphonates (zoledronate, ibandronate and, from 2007, clodronate) were administered as a long-term supportive therapy. A one-year follow-up skiagram of the left femur revealed over 50% regression of the osteolytic lesion (10 x 5 mm) documented in a set of pictures herein.
  
  
  CONCLUSIONS
  A complete remission of the disease after an administration of bortezomib (Velcade)-based regimen in a long-term clodronate (Bonefos)-treated patient with relapsed multiple myeloma is radiographically apparent by clear healing signs of the osteolytic bone lesion.
authors: Interní hematoonkologická klinika, LF MU a FN Brno. petr.szturz@fnbrno.cz
authors: P
authors: P
authors: Szturz
authors: R
authors: R
authors: Jakubcová
authors: Z
authors: Z
authors: Adam
authors: M
authors: M
authors: Klincová
authors: M
authors: M
authors: Krejcí
authors: L
authors: L
authors: Pour
authors: L
authors: L
authors: Zahradová
authors: R
authors: R
authors: Hájek
authors: J
authors: J
authors: Mayer
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage*; D000069286:Bortezomib; D004002:Clodronic Acid / Q000627:therapeutic use*; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D010014:Osteolysis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011719:Pyrazines / Q000008:administration & dosage*; D011859:Radiography; D012008:Recurrence; D012074:Remission Induction
chemical_list: D000970:Antineoplastic Agents; D050071:Bone Density Conservation Agents; D001897:Boronic Acids; D011719:Pyrazines; D004002:Clodronic Acid; D000069286:Bortezomib