EXTRATUMOR MECHANISMS OF OSTEOLYSIS IN MU LTIPLE-MYELOMA AND METHOD OF THEIR CORRECTION

In 70 patients with stage III multiple myeloma (MM) the authors studie d spontaneous and lipopolysaccharide-induced production of interleukin -1 (IL-1) and interleukin-6 (IL-6) by blood and bone marrow mononuclea r cells, concentration of parathyroid hormone and vitamin D3 in the se rum. Bone marrow density was measured at photon absorption (Gambro), i n patients treated with osteoprotectors bonefos and oxidevit before an d after therapy (3.5-6 month course). It is shown that in MM there is a pathogenetic association between production of osteotropic IL-1, IL- 6 and bone demineralization. The cases with reduced concentration of C a and P ions in the serum (4 and 5.7% of patients, respectively) and i ncreased PTH concentration (7%) suggest the existence of new, extratum or mechanisms of osteolysis. It is found that biphosphonates are optim al osteoprotectors. Bonefos (chlodronat, Lieras, Finland) arrests oste olysis proved by a significant increase of bone marrow density and cli nical effect.