Hematopoietic progenitor cell transplantation toxicities in multiple myeloma patients with bisphosphonate-induced osteonecrosis of the jaw: a longitudinal cohort study

• Published in: Supportive care in cancer Vol. 20; no. 11; pp. 2969 - 2975
• Main Authors: Varadarajan, Prakash, Toro, Juan J., Lee, Shuko, Schneider, Deanna, Neumon, Bonita, Frye, Brenda, Craig, Robert M., Haile, David J., Freytes, César O.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.11.2012; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Analysis; Bisphosphonate-Associated Osteonecrosis of the Jaw - pathology; Bone Density Conservation Agents - administration & dosage; Bone Density Conservation Agents - adverse effects; Bones; Case-Control Studies; Cells; Cohort Studies; Diphosphonates - administration & dosage; Diphosphonates - adverse effects; Drug therapy; Follow-Up Studies; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - methods; Humans; Length of Stay; Longitudinal Studies; Male; Medical disorders; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Mouth; Multiple myeloma; Multiple Myeloma - therapy; Necrosis; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Rehabilitation Medicine; Retrospective Studies; Severity of Illness Index; Stem cells; Survival Rate; Toxicity; Transplantation; Transplantation, Autologous; Transplants & implants; Treatment Outcome; Osteonecrosis of the jaw; Multiple myeloma; Autologous hematopoietic progenitor cell transplantation
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-012-1429-4

Purpose There is no information regarding the toxicity associated with autologous hematopoietic progenitor cell transplantation (AHPCT) in patients with multiple myeloma (MM) who have bisphosphonate-induced osteonecrosis of the jaw (ONJ). There is also limited information regarding long-term outcome of these patients. Methods In this retrospective cohort study, we compared the toxicity after AHPCT in MM patients with and without ONJ. We also analyzed the response rate and overall survival of this population of patients. Results During the study period, 176 patients underwent AHPCT at our institution for MM. Ten patients with ONJ prior to AHPCT were matched to 40 control patients without ONJ. The incidence and severity of transplantation-associated toxicities were similar in both groups, including mucositis, 50 % in patients with ONJ vs. 68 % in controls ( p  = 0.889) and febrile days, median 1 vs. 3 days, respectively ( p  = 0.524). Myeloid engraftment and hospital length of stay were also similar between patients with ONJ and controls. There were significantly more complete remissions in patients with ONJ than in control patients (45 % vs. 15 %, p  = 0.0336), but survival between the groups was not significantly different (log-rank p  = 0.0818). Conclusions We conclude that the incidence and severity of transplantation-associated toxicities are similar in MM patients with and without ONJ. Long-term survival was also similar between both groups.