Table 6.

New Recommendations for Use of Bisphosphonates in Multiple Myeloma

Factor	Recommendation
Patient population	Newly diagnosed patients with MM who require antimyeloma treatment (regardless of bone status)
Administration	IV
Duration/frequency	Monthly during initial therapy and ongoing in patients who are not in remission
	After 2 years, discontinue if CR/VGPR; continue if ≤ PR
Monitoring	Monthly creatinine clearance
Choice	ZOL (first option)
	PAM (second option)
	CLO (only in patients who cannot come to hospital, those with severe disabilities, and those with contraindications to ZOL and PAM)

Abbreviations: CLO, clodronate; CR, complete response; IV, intravenous; MM, multiple myeloma; PAM, pamidronate; PR, partial response; VGPR, very good partial response; ZOL, zoledronic acid.