title: Incidence and risk factors of bisphosphonate-related osteonecrosis of the jaw in multiple myeloma patients having undergone autologous stem cell transplantation.
abstract: BACKGROUND
  Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a severe complication of bisphosphonate therapy. Due to their long survival and subsequently high cumulative doses of bisphosphonates, multiple myeloma patients have the highest risk of developing BRONJ of all patients treated with bisphosphonates. The purpose of the present study was to evaluate the incidence and risk factors for BRONJ in multiple myeloma patients after high-dose chemotherapy and autologous stem cell transplantation (ASCT).
  
  
  METHODS
  We retrospectively analyzed the data of 120 multiple myeloma patients after high-dose chemotherapy and ASCT treated with bisphosphonates and assessed the incidence and risk factors of BRONJ.
  
  
  RESULTS
  Of the 120 patients, 23 (19%) developed BRONJ. 6 patients suffered several BRONJ events, resulting in a total incidence of 23%. The risk for BRONJ was significantly higher for patients with rheumatism and recent dental manipulations. Furthermore, the number of previous bisphosphonate rotations, the duration of bisphosphonate therapy, and the type and cumulative dose of bisphosphonate used were associated with the incidence of BRONJ.
  
  
  CONCLUSIONS
  Our study is the first to determine the risk of BRONJ in a homogeneous group of multiple myeloma patients treated with high-dose chemotherapy and ASCT.
authors.affiliation: Division of Endocrinology and Diabetology, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Germany.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Then
authors.forename: Natalie
authors.initials: N
authors.lastname: Hörauf
authors.forename: Sven
authors.initials: S
authors.lastname: Otto
authors.forename: Christoph
authors.initials: C
authors.lastname: Pautke
authors.forename: Emmo
authors.initials: E
authors.lastname: von Tresckow
authors.forename: Tim
authors.initials: T
authors.lastname: Röhnisch
authors.forename: Philipp
authors.initials: P
authors.lastname: Baumann
authors.forename: Ralf
authors.initials: R
authors.lastname: Schmidmaier
authors.forename: Irmgard
authors.initials: I
authors.lastname: Bumeder
authors.forename: Fuat S
authors.initials: FS
authors.lastname: Oduncu
mesh_terms: D000328:Adult; D000368:Aged; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000175:diagnosis / Q000453:epidemiology*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology* / Q000628:therapy*; D020266:Radiotherapy, Conformal / Q000706:statistics & numerical data*; D012307:Risk Factors; D033581:Stem Cell Transplantation / Q000706:statistics & numerical data*; D016896:Treatment Outcome