Bone Disorders

I think that there has been a misunderstanding over terminology. The answer given by Health talk was perfectly correct, but it wasn't answering your implied question. Bone comprises an outer thick and hard layer, called the cortex and an inner center called the medulla (or marrow) The Medulla is like a honeycomb with hard bony walls (known as trabeculae) interspersed bu open spaces that consist of fat spaces and bone marrow cells. It here that the blood is made, and in CLL (or SLL) these honeycomb spaces are gradually filled up with CLL cells to the detriment of normal marrow production.

In multiple myeloma, the same thing happens except that the spaces are filled up with plasma cells, and the plasma cells secrete chemicals that activate the bone modelling cells called osteoclasts, which eat away at the bony trabeculae and eventually the cortical bone. So they cause fractures which are the major cause of clinical problems in myeloma.

Normally this does not happen in CLL, but occasionally it may, and you seem to be one of the unlucky exceptions. The treatment is with the class of drugs known as bisphosphonates. Aredia and Zometa are examples of these. These drugs are also used for the treatment of people whose bone starts thinning in this way in old age, and also in breast cancer, where true metastases in the bone occur.

Dr. Hamblin and/or others, I have CLL and osteoporosis. After a year on Actonel, my bone density worsened, so the specialist recommended one infusion of Zometa per year. I don't recall the dosage. My oncologist recommended that I get it every 3 months, rather than annually.

What is the correct dosage and frequency of Zometa when it is prescribed for osteoporosis?

Zometa is only licensed for bone thinning due to malignant disease, not for osteoporosis. the dose for malignant bone thinning is 4mg in a 15 minute infusion given every 3 weeks. Other bisphosphonates are used for osteoporosis.