Use of bisphosphonates in hematology

Abstract

Bisphosphonates (BPs) are used in the treatment of bone diseases associated with hematologic pathologies. BP therapy is, in fact, the mainstay of treatment for bone disease in multiple myeloma (MM) patients. These drugs decrease the frequency and delay the development of skeletal events in MM. Moreover BPs are used for the treatment of the malignancy-associated hypercalcemia seen in patients with blood diseases, such as MM and adult T-cell leukemia/lymphoma. Finally, an anti-tumor effect of BPs in MM patients has been described. However, BP-induced osteonecrosis of the jaw (BIONJ) is an unremitting adverse outcome. This chapter reviews the current theories explaining the mechanism for this complication. We report evidence for the use of BPs in hematologic diseases and provide recommendations to guide the clinical practice of treating bone disease in hematologic patients.