IMWG Guidelines for the Use of Bisphosphonates in Myeloma

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Intravenous bisphosphonate therapy has been amply demonstrated to reduce bone complications of myeloma.   Bisphosphonate (BP) therapy is therefore an important component of supportive care for myeloma patients with boney disease. Adverse events associated with BP are usually mild and consist of fever, renal function impairment, myalgias, and hypocalcemia.  A more serious potential side effect of bisphosphonate therapy that was first identified in 20031 is osteonecrosis of the jaw (ONJ), a debilitating problem that can be associated with significant morbidity. The following guidelines for the use of bisphosphonate therapy in myeloma are based upon IMWG and Mayo Clinic guidelines2,3 and are intended to provide safe criteria for bisphosphonate use to minimize […]