My husband has achieved partial remission of multiple myeloma after a course of treatment with Revlimid. After only six treatments with pamidronate (Aredia) (4) and zolendronate (Zometa) (2), he developed bisphosphonate-related osteonecrosis of the jaw (BRONJ) last February.
Because of partial remission of the multiple myeloma, his doctors say this is a good time to complete a stem cell transplant. His oral surgeons who have been treating the BRONJ conservatively and with hyperbaric treatments say it would be too risky to his jaw to enter the stem cell transplant with initial melphalan chemotherapy.
Has anyone had experience with undergoing stem cell transplant( autologous) with the condition of unhealed lesion of jaw.?
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Re: Stem cell transplant with BRONJ
Kathyrn,
We have the same question that you do regarding stem cell transplant with BRONJ. Unfortunately we have not had luck getting answers. As your post is several months old, have you found any information since then? Did your husband have the stem cell transplant?
My brother is faced with the same dilemma. He is 45 yrs old, was preparing for BMT, and developed BRONJ after a few treatments with Zometa. His oral surgeon said he should be OK for transplantation, and that transplant may even help improve the BRONJ, but it seems like the infection risk would be too high. His unhealed gum lesion is very small (few millimeters), but there is exposed bone. No sign of infection, and its currently being treated conservatively with mouth rinses and antibiotics.
Anyone have info on stem cell transplant with osteonecrosis of the jaw?
Thanks,
Michael
We have the same question that you do regarding stem cell transplant with BRONJ. Unfortunately we have not had luck getting answers. As your post is several months old, have you found any information since then? Did your husband have the stem cell transplant?
My brother is faced with the same dilemma. He is 45 yrs old, was preparing for BMT, and developed BRONJ after a few treatments with Zometa. His oral surgeon said he should be OK for transplantation, and that transplant may even help improve the BRONJ, but it seems like the infection risk would be too high. His unhealed gum lesion is very small (few millimeters), but there is exposed bone. No sign of infection, and its currently being treated conservatively with mouth rinses and antibiotics.
Anyone have info on stem cell transplant with osteonecrosis of the jaw?
Thanks,
Michael
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MichaelC
Re: Stem cell transplant with BRONJ
This may be a little off topic, but I too have multiple myeloma since November 2013. I have been on a Revlimid, dexamethasone and Zometa regimen since. My oncologist says that I'm not a good candidate for stem cell transplant due to being almost asymptomatic with no kidney failure and age, 72, but supposedly Medicare will pay for one up to I think age 75, so he is holding that in reserve.
This past late August I too developed BRONJ manifesting itself as a bone growth out of my lower right jaw behind my last existing tooth. My original thought was that I had a tooth growing there where one had been removed (#31) many years ago. When I saw my dentist she said it was a root top, but would not touch it since I was a multiple myeloma person and sent me to an oral surgeon.
Fortunately the OS was very knowledgeable and recognized it immediately as BRONJ. He did cut away the exposed bone and the hope was that it would heal over. Well, it didn't, and he recommended that I contact my oncologist, which he happens to know personally, and have him take me off my Revlimid, Zometa and also alendronate (Fosamax) that was prescribed by my primary care physician for early stage osteoporosis.
This was done and a three week later checkup showed no appreciable change in the BRONJ. The oral surgeon said it may take several weeks to a few months to get past the affect of the multiple myeloma drugs that I have been on, so I have another appointment the end of this month.
One of the side affects of the BRONJ was excruciating throbbing pain in the jaw that over the counter pain relievers did not begin to touch. I got the OS to reluctantly prescribe Vicodin [oxycodone + acetaminophen / paracetamol], but he only wanted me to take half a pill every 6 to 8 hours, and that did not help at all. I then contacted my oncologist and he had no trouble prescribing 100 tablets and my taking 1 or 2 every 6 to 8 hours. At my age quality of life is much more important than possible problems from medications, and my oncologist seems to be on the same page with me.
The real good news is that the pain in my jaw has now subsided and I'm no longer taking Vicodin and usually no over counter pain pills. I do have another affect of the BRONJ that the OS warned me about, and that is pretty severe pain in my hips and down my legs like sciatica. It comes and goes, but interesting the pain is completely gone for two days after taking my dexamethasone.
Also, on a another issue, when taking dexamethasone, I usually can't sleep for the next two nights as it's a steroid and cranks me up. For that, I got the oncologist to prescribe Ambien, and that does help some. I actually got 7 hours of continuous sleep this past Tuesday, which is the first time I got more than 3 or 4 in the past couple of years, as I also have BPH and am being treated with Flomax.
Sorry this is so verbose, but thought I should include the details in case it affects others.
Best wishes to all.
This past late August I too developed BRONJ manifesting itself as a bone growth out of my lower right jaw behind my last existing tooth. My original thought was that I had a tooth growing there where one had been removed (#31) many years ago. When I saw my dentist she said it was a root top, but would not touch it since I was a multiple myeloma person and sent me to an oral surgeon.
Fortunately the OS was very knowledgeable and recognized it immediately as BRONJ. He did cut away the exposed bone and the hope was that it would heal over. Well, it didn't, and he recommended that I contact my oncologist, which he happens to know personally, and have him take me off my Revlimid, Zometa and also alendronate (Fosamax) that was prescribed by my primary care physician for early stage osteoporosis.
This was done and a three week later checkup showed no appreciable change in the BRONJ. The oral surgeon said it may take several weeks to a few months to get past the affect of the multiple myeloma drugs that I have been on, so I have another appointment the end of this month.
One of the side affects of the BRONJ was excruciating throbbing pain in the jaw that over the counter pain relievers did not begin to touch. I got the OS to reluctantly prescribe Vicodin [oxycodone + acetaminophen / paracetamol], but he only wanted me to take half a pill every 6 to 8 hours, and that did not help at all. I then contacted my oncologist and he had no trouble prescribing 100 tablets and my taking 1 or 2 every 6 to 8 hours. At my age quality of life is much more important than possible problems from medications, and my oncologist seems to be on the same page with me.
The real good news is that the pain in my jaw has now subsided and I'm no longer taking Vicodin and usually no over counter pain pills. I do have another affect of the BRONJ that the OS warned me about, and that is pretty severe pain in my hips and down my legs like sciatica. It comes and goes, but interesting the pain is completely gone for two days after taking my dexamethasone.
Also, on a another issue, when taking dexamethasone, I usually can't sleep for the next two nights as it's a steroid and cranks me up. For that, I got the oncologist to prescribe Ambien, and that does help some. I actually got 7 hours of continuous sleep this past Tuesday, which is the first time I got more than 3 or 4 in the past couple of years, as I also have BPH and am being treated with Flomax.
Sorry this is so verbose, but thought I should include the details in case it affects others.
Best wishes to all.
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