The effect of the combination of bisphosphonates and conventional chemotherapy on bone metabolic markers in multiple myeloma patients.

PURPOSE: Urinary N-terminal telopeptides of type I collagen (uNTX), serum bone alkaline phosphatase (sBAP) have been acknowledged in observing bone metastases of solid tumors. The paper is designed to study the value of clinical application of uNTX and sBAP in the treatment of multiple myeloma (MM), as well as the action of bisphosphonates for osteolytic bone lesion.

METHODOLOGY: Thirty-three MM cases were treated with bisphosphonates (hereinafter called clodronate therapy group) and 20 MM cases were treated with simple chemotherapy (hereinafter called control group). uNTX and sBAP were tested during the courses of treatment three times (pretreatment, 3 months, and 6 months). uNTX was tested by enzyme-linked immunosorbent assay. sBAP was tested by chemiluminescence analysis. All the results were analyzed with t-test by using SPSS 11.0.

RESULTS

There were no significant differences between therapy and control groups: in uNTX (173.74 ± 14.55) and (129.79 ± 12.13) μg/l before treatment (P > 0.05). After 6 months there were significant differences between them: (85.71 ± 8.23) and (121.59 ± 12.43) μg/l (P < 0.05). And also there were significant differences among the courses in the therapy group. There were no significant differences between therapy and control groups in sBAP concentration: (4.78 ± 0.55) and (8.42 ± 1.32) μg/l before treatment (P > 0.05). After 6 months there were significant differences between them: (16.01 ± 0.52) and (9.62 ± 1.29) μg/l (P < 0.001). And also there were significant differences among the courses in the therapy group.

CONCLUSION

uNTX and sBAP were important to measure the situation of the osteolytic bone lesion in MM. Bisphosphonates can significantly reduce bone degradation and metabolism, improve the synthesis, which is valuable for the treatment of MM cases.