Osteonecrosis of the jaws in newly diagnosed multiple myeloma patients treated with zoledronic acid and thalidomide-dexamethasone

Abstract

In an attempt to identify the incidence of ONJ in a large, homogeneous series of patients with newly diagnosed multiple myeloma (MM) and to define the possible pathogenetic role of concurrent antimyeloma therapy, we retrospectively reviewed a series of 259 consecutive patients with symptomatic MM who were enrolled in the Bologna 2002 clinical trial.³ By study design, all patients received 4 months of primary therapy with thalidomide (200 mg/d) combined with high-dose dexamethasone (40 mg/d on days 1-4, 9-12, and 17-20 on odd cycles and on days 1-4 on even cycles) followed by double autologous transplantation with 200 mg melphalan/m². Daily thalidomide (200 mg/d) and monthly courses of dexamethasone were continued until the second autologous transplantation. Intravenous zoledronic acid 4 mg every 28 days was administered throughout the whole treatment period and continued thereafter, at physician's discretion. Only patients receiving zoledronic acid for longer than 4 months were included in the present analysis.