title: Micro-osteoclast resorption as a characteristic feature of B-cell malignancies other than multiple myeloma.
abstract: Multiple myeloma (MM) is characterized by the presence of lytic bone lesion and frequent hypercalcaemia. These are due to an excessive osteoclastic resorption in association with a low bone formation, as demonstrated by bone histomorphometry. Conversely, B-cell malignancies other than MM are rarely associated with lytic bone lesion and/or hypercalcaemia. In this study we have analysed quantitative bone histology in 65 patients with B-cell malignancies other than MM at diagnosis: chronic lymphocytic leukaemia (CLL, n = 20), non-Hodgkin's lymphoma (NHL, n = 25), Waldenström's disease (WD, n = 14), hairy cell leukaemia (HCL, n = 6). Fifty patients presented no clinical evidence of increased bone resorption, including no lytic bone lesions radiologically detectable and/or no hypercalcaemia. 80% of these patients (40/50) had increased bone resorption parameter using quantitative bone histology, including 19/29 (65.5%) patients with CLL or WD and 21/21 (100%) patients with NHL or HCL (P less than 0.01). As a control group, seven patients lacking bone marrow involvement on bone sample presented no excessive bone resorption. However, eight patients presented lytic bone lesions and/or hypercalcaemia. All of these patients had increased resorption parameters with high numbers of osteoclasts per surface trabecular bone (mean = 35.3), as opposed to the patients lacking lytic bone lesions and/or hypercalcaemia (mean = 6.6, n = 28) and to normal individuals (mean +/- SD = 3.8 +/- 1.7 and 6.3 +/- 2.6, respectively before and after 60 years). In all the cases, excessive histologic bone resorption was mediated by mononuclear small osteoclasts (mean osteoclast length +/- SD = 27.3 +/- 4.1 as compared to normal range = 35.0 +/- 1.0, P less than 0.001). In different in vitro models, these small mononuclear osteoclasts are considered as progenitors. These data suggest an abnormal osteoclast differentiation in B-cell malignancies other than MM, probably due to differences in the production of local factors acting on bone remodelling.
authors: Departement d'Oncologie Médicale et d'Immunothérapie, Institut du Cancer (Val d'Aurelle II), Montpellier, France.
authors: J F
authors: JF
authors: Rossi
authors: D
authors: D
authors: Chappard
authors: C
authors: C
authors: Marcelli
authors: J
authors: J
authors: Laplante
authors: T
authors: T
authors: Commes
authors: P
authors: P
authors: Baldet
authors: C
authors: C
authors: Janbon
authors: J
authors: J
authors: Jourdan
authors: C
authors: C
authors: Alexandre
authors: R
authors: R
authors: Bataille
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001402:B-Lymphocytes / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology; D001862:Bone Resorption / Q000209:etiology*; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications* / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000473:pathology; D010007:Osteochondritis / Q000150:complications* / Q000473:pathology; D010010:Osteoclasts / Q000473:pathology*