2011
DOI: 10.2106/jbjs.j.00455
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Metatarsal Stress Fractures in Patients with Multiple Myeloma Treated with Long-Term Bisphosphonates

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Cited by 13 publications
(7 citation statements)
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“…For multiple myeloma, most recent consensus guidelines recommend monthly aBP treatment for a period of 2 years (3,4). However, it is unknown whether monthly dosing of aBPs is optimal, as there are consequences of long-term aBP therapy, such as osteonecrosis of the jaw (ONJ) and atypical stress fractures (3)(4)(5)(6)(7)(8)(9). Bisphosphonate-related ONJ is characterized by bone that is necrotic and exposed, located in the maxillofacial area, and present for at least 8 weeks in a patient with history of bisphosphonate treatment, but no history of prior radiation to that area (10).…”
Section: Introductionmentioning
confidence: 99%
“…For multiple myeloma, most recent consensus guidelines recommend monthly aBP treatment for a period of 2 years (3,4). However, it is unknown whether monthly dosing of aBPs is optimal, as there are consequences of long-term aBP therapy, such as osteonecrosis of the jaw (ONJ) and atypical stress fractures (3)(4)(5)(6)(7)(8)(9). Bisphosphonate-related ONJ is characterized by bone that is necrotic and exposed, located in the maxillofacial area, and present for at least 8 weeks in a patient with history of bisphosphonate treatment, but no history of prior radiation to that area (10).…”
Section: Introductionmentioning
confidence: 99%
“…Regarding the reports of MTFs in patients treated for multiple myeloma with BPs [22,23], it is unlikely that the fractures were pathologic lesions secondary to the malignancy. A survey [24] of the Mayo Clinic records of 165 persons with the diagnosis of multiple myeloma treated in the years 1945-2001 (before the use of intravenous BP treatments) found no cases of spontaneous or pathologic MTFs.…”
Section: Resultsmentioning
confidence: 99%
“…33,34 Despite the initial response, prolonged use of aminobisphosphonates often results in osteonecrosis of the jaw and atypical stress fractures. [35][36][37][38][39][40][41] Although the classical pathways activating osteoclast functions are well known in myeloma bone lesions, testing of novel approaches is hampered by a lack of appropriate preclinical models exhibiting adequate window for disease progression with characteristics of disseminated disease in major bones. Toward advancing and testing a genetically engineered stem cell therapy by a systemic approach, targeting osteolytic pathology in myeloma, we first developed a mouse model using the human myeloma cell lines, overexpressing heparanase.…”
Section: Discussionmentioning
confidence: 99%