PYRIDINIUM CROSS-LINKS IN MULTIPLE-MYELOMA - CORRELATION WITH CLINICAL-PARAMETERS AND USE FOR MONITORING OF INTRAVENOUS CLODRONATE THERAPY - A PILOT-STUDY OF THE GERMAN MYELOMA TREATMENT GROUP (GMTG)

The relevance of quantitative determinations of urinary deoxypyridinol ines (DPY) and pyridinolines (PY), and of serum type I collagen carbox yterminal cross-linked telopeptides (ICTP), has been evaluated for pat ient monitoring in multiple myeloma (MM). In 178 untreated MM patients , a clear correlation was found between ICTP concentrations, bone dest ructions and serum calcium levels. Furthermore, serum ICTP, urinary DP Y and PY concentrations were estimated before and during treatment in a further 33 MM patients randomly allocated to four groups receiving i ntravenous melphalan/prednisone (MivP) chemotherapy alone, or MivP in combination with three different doses of i.v. clodronate. 1800 mg of i.v. clodronate combined monthly with MivP induced a rapid and sustain ed reduction in bone resorption parameters to the normal range, a resu lt not obtained with either MivP alone, or with a lower clodronate dos e. While confirming the relevance of determining pyridinium cross-link s for estimating bone resorption in MM, our data indicate that measure ments of these parameters could be useful for dose finding and monitor ing of bisphosphonate therapy. Copyright (C) 1996 Elsevier Science Ltd