title: Hematopoietic progenitor cell transplantation toxicities in multiple myeloma patients with bisphosphonate-induced osteonecrosis of the jaw: a longitudinal cohort study.
abstract: OBJECTIVE
  There is no information regarding the toxicity associated with autologous hematopoietic progenitor cell transplantation (AHPCT) in patients with multiple myeloma (MM) who have bisphosphonate-induced osteonecrosis of the jaw (ONJ). There is also limited information regarding long-term outcome of these patients.
  
  
  METHODS
  In this retrospective cohort study, we compared the toxicity after AHPCT in MM patients with and without ONJ. We also analyzed the response rate and overall survival of this population of patients.
  
  
  RESULTS
  During the study period, 176 patients underwent AHPCT at our institution for MM. Ten patients with ONJ prior to AHPCT were matched to 40 control patients without ONJ. The incidence and severity of transplantation-associated toxicities were similar in both groups, including mucositis, 50 % in patients with ONJ vs. 68 % in controls (p = 0.889) and febrile days, median 1 vs. 3 days, respectively (p = 0.524). Myeloid engraftment and hospital length of stay were also similar between patients with ONJ and controls. There were significantly more complete remissions in patients with ONJ than in control patients (45 % vs. 15 %, p = 0.0336), but survival between the groups was not significantly different (log-rank p = 0.0818).
  
  
  CONCLUSIONS
  We conclude that the incidence and severity of transplantation-associated toxicities are similar in MM patients with and without ONJ. Long-term survival was also similar between both groups.
authors.affiliation: South Texas Veterans Health Care System, San Antonio, TX, USA. varadarajan@uthscsa.edu
authors.forename: Prakash
authors.initials: P
authors.lastname: Varadarajan
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Toro
authors.forename: Shuko
authors.initials: S
authors.lastname: Lee
authors.forename: Deanna
authors.initials: D
authors.lastname: Schneider
authors.forename: Bonita
authors.initials: B
authors.lastname: Neumon
authors.forename: Brenda
authors.initials: B
authors.lastname: Frye
authors.forename: Robert M
authors.initials: RM
authors.lastname: Craig
authors.forename: David J
authors.initials: DJ
authors.lastname: Haile
authors.forename: César O
authors.initials: CO
authors.lastname: Freytes
mesh_terms: D000328:Adult; D000368:Aged; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000473:pathology*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016022:Case-Control Studies; D015331:Cohort Studies; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates