THE SUPPORTIVE CARE OF BONE-DISEASE IN MU LTIPLE-MYELOMA

In the text are summarized the results of studies dealing with support ive therapy of multiple myeloma bone disease. The similarities of prim ary osteoporosis acid osteoporosis in multiple myeloma raised a hope t hat sodium fluoride will help to prevent or to slow down the osteoporo tic process in multiple myeloma patients. The first studies in small g roups of patients reported some advantage for the patients with sodium fluoride, later in randomized studies no benefit of sodium fluoride w as confirmed. The effect of calcitonin was studied in small groups of patients. All studies confirmed analgetic effect and some of them prov ed positive effect on the amount of bone hydroxyapatite by a histomorp hometric examination. The contribution of bisphosphonate to the therap y of myeloma patients was confirmed in extensive studies. With the exc eption of a Canadian study with ethidronate, all studies reported good analgetic effects and the inhibitory influence on bone destruction. T he advantage of bisphosphonates in comparison to calcitonin is the pos sibility of p.o, administration or in i.v. periodical administration s everal times a year.