MULTIPLE-MYELOMA AND BONE MANIFESTATIONS - PLACE OF CLODRONATE

Osteolytic lesions in multiple myeloma are related to osteclast activa tion induced by a network of cytokines including IL-6, TNF beta or IL1 beta which explain pain, fractures, or hypercalcaemia appearance. Bon e destruction is reflected by hydroxyprolinuria and inversely correlat ed with serum osteocalcin. Lytic lesions or osteopenia are present in 80 % of patients on X-ray. MR imaging, is interesting for exploring sp inal lesions or the so-called solitary plasmacytomas but still remains a tool in evaluation. After therapies few modifications are demonstra ted on roentgenograms while osteodensitometry appears more sensitive. A review of the literature is made showing the prominent place of clod ronate in the therapy of hypercalcaemia of multiple myeloma. This drug appears attractive for decreasing osteolysis and perhaps for improvin g quality of life of patients. Nevertheless, a better definition of it s use in clinical practice is necessary.