The problem of osteoporosis is world-wide in people above 50 years of age. As this period is also a risk period for the development of multiple myeloma or other malignant processes, comprehen- sive differential diagnosis of malignant and benign osteoporosis is essential. By retrospective analysis of a 12-year group of 270 patients treated by chemotherapy on account of multiple myeloma the authors selected a group of 151 patients treated in addition to chemothe- rapy and immunomodulating drugs (mixture of proteolytic enzymes - Wobe Mugos) for 2-3 years, also with biphosphonates.At the time ofdiagnosis osteoporosis was in 24.5% patients the only finding on bones. When biphosphonates (Bonefos, Ibandronate) and chemotherapy were administered during a three-year observation period the bone process was stable in 61.59%, osseous changes disappea- red in 11.26% and progression of osteolysis was recorded in 27.15% The objective of the work was to emphasize the importance of a correct diagnosis of osseous changes which can progress even in clinically asymptomatic myelomas.

        Key words: Osteoporosis in multiple myeloma - Immunochemotherapy of plasmocytoma - Treat- ment of myeloma with biphosphonates Bonefos and Ibandronate in myeloma.