[Kahler's disease. Multiple myeloma]

Kahler's disease, multiple myeloma, is a malignant condition of unbridled multiplication of plasma cells in bone marrow. Clinical features are anaemia, pain in the affected bones, spontaneous bone fractures and increased infection susceptibility. In the final stage of the disease severe renal failure can occur. With the present chemotherapy a good response is seen in 50-70% of patients, but complete response occurs only in a minority of patients. Radiotherapy is often used in addition to chemotherapy. Bisphosphonates are used to inhibit osteolysis and to prevent complications associated with osteolysis. Recently, an association was found between use of bisphosphonates and jaw osteonecrosis. In order to minimize the risk of complications, it is advocated to be in touch with the patients haematologist before starting an invasive oral treatment.