Bone-Modifying Agents in Multiple Myeloma

Publication Date: January 17, 2018

Key Points

Key Points

  • The definition of active multiple myeloma requiring therapy has been revised. HyperCalcemia, Renal dysfunction, Anemia or Bone disease (CRAB) remain indications for treatment.
  • In the absence of these CRAB features, patients who have >60% bone marrow plasma cells, involved free light chain >100 mg/L with kappa/lambda ratio >100 fold, or more than one site of bone disease on MRI or on PETCT scanning are now recommended for treatment.
  • Any patient who is on treatment for active multiple myeloma should receive bisphosphonate therapy.
  • Clodronate is approved worldwide, except in the United States, for either oral or intravenous administration. However, the recent MRC IX RCT shows that intravenous zoledronic acid is superior in avoiding skeletal complications.



...ndications to initiate a BM...

...h Lytic Disease on Plain Radiographs...

...e 1. Estimated Prices for Bone Modifying...