Effect of pamidronate administration on markers of bone turnover and disease activity in multiple myeloma

Abstract

These results suggest that pamidronate may have a synergistic action with chemotherapy in decreasing osteoclastic activity, in reducing markers of myeloma activity and myeloma related pain and in improving the quality of life in patients with MM.

The use of biochemical markers of bone remodeling in multiple myeloma: a report of the International Myeloma Working Group

“…In contrast, measurement of bone formation markers seem to be of limited prognostic value. 71 Bone markers during anti-resorptive therapy Biochemical markers of bone turnover have been used in MM both to monitor bisphosphonate treatment, and to determine 71 Terpos et al showed that the addition of pamidronate to CC significantly reduced urinary NTX and disease-related pain compared with CC alone, 49 and that pamidronate in combination with interferon-a induced bone formation in MM patients at plateau phase. 61 Ibandronate at a dose of 2 mg showed a substantial reduction of CTX and OC in only one-third of MM patients, 74 whereas in a randomized study, monthly pamidronate (90 mg, IV) produced a greater reduction of NTX and TRACP-5b compared with monthly ibandronate (4 mg, IV).…”

“…Table 3 summarizes the results of the most important studies to date regarding the levels of bone markers in MM patients. [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60] As has been shown in multiple studies, urine levels of PYD, DPD and NTX and serum levels of CTX, ICTP and TRACP-5b were elevated in MM patients compared with healthy controls, and correlated with the extent of osteolytic disease. 46,48,[51][52][53][54][55][56][58][59][60] Urinary NTX levels were increased even in myeloma patients who had reached a clinical plateau phase of their disease, 61 whereas PYD, DPD and NTX were also elevated in myeloma patients before autologous transplantation.…”

“…[43][44][45][46][48][49][50][51]53,55,56 In some studies, bALP and OC were elevated in myeloma patients compared with controls, whereas in others they were either reduced or within normal limits. In a study by Fonseca et al, which included a large number of myeloma patients (n ¼ 313), serum bALP correlated with bone pain, lesions and fractures, whereas OC levels were lower in myeloma patients than in controls but did not correlate with the extent of bone disease.…”

Soluble receptor activator of nuclear factor κB ligand–osteoprotegerin ratio predicts survival in multiple myeloma: proposal for a novel prognostic index

“…[5][6][7][8] Bone alkaline phosphatase (bALP) and osteocalcin (OC), markers of bone formation, are strongly suppressed in MM patients. 9 The overproduction of cytokinesincluding interleukin-6 (IL-6), IL-1␣, tumor necrosis factor-␣ (TNF-␣), and TNF-␤-by stromal and myeloma cells had been recognized as the major factors for activating osteoclasts. 10 Characterization of the receptor activator of nuclear factor B ligand (RANKL) and its decoy receptor osteoprotegerin (OPG) system has facilitated understanding the pathophysiology of bone disease in MM.…”

High-dose Cyclophosphamide as an Effective Therapy for a Patient with Refractory Multiple Myeloma Relapsing after Autologous Stem Cell Transplantation

“…On this point, Terpos et al reported the effect of pamidronate (10). They divided patients with MM into two groups, chemotherapy with pamidronate and chemotherapy alone.…”