Pamidronate induces bone formation in patients with smouldering or indolent myeloma, with no significant anti-tumour effect.

Twelve patients with smouldering or indolent multiple myeloma (MM) received 12 courses of intravenous pamidronate as a single agent to evaluate both the antitumour and bone metabolism effects. One patient achieved minor response, eight had stable disease, and three - all indolent MM - showed disease progression. Serum interleukin 6 (IL-6), IL-1beta and Oncostatin-M remained stable throughout the study, while tumour necrosis factor-alpha increased. Bone density significantly increased after four and 12 courses compared with baseline. Markers for bone resorption and bone formation decreased with treatment. These results suggest that pamidronate treatment reduces bone turnover in smouldering or indolent MM, but has no significant antitumour effect.