Abstract
Bisphosphonates should be initiated in all patients with multiple myeloma receiving first-line antimyeloma therapy, regardless of presence of osteolytic bone lesions on conventional radiography. Intravenous zoledronic acid is preferred over oral clodronate in newly diagnosed patients because of its potential antimyeloma effects and survival benefits.
Bisphosphonates should be discontinued after one to two years if complete or very good partial remission (VGPR) is achieved. Preventive strategies must be instituted to avoid renal toxicity or osteonecrosis of the jaw.