[Bone histomorphometry in monoclonal dysglobinemia. Diagnostic and prognostic value].
Data of bony histomorphometry by transiliac biopsy were studied in 35 cases of multiple myeloma and 26 cases of benign monoclonal dysglobulinemia. In a first stage, the comparison between the two groups showed an osteoclastic resorption which was significantly higher in myeloma patients in osteolytic forms as well as asymptomatic forms, showing the diagnostic advantage of this measurement in these forms of the disease. Also, the association of a preservation of the bony trabecular volume with an osteoclastic hyper-resorption was only observed in myeloma patients. In a second stage, study of the evolution of myeloma patients permitted to demonstrate the pejorative prognostic value of an intense hyper-resorption (STRO greater than or equal to 6) from a vital point of view as well as the future of the bone; patients with an initial hyper-resorption develop an osteolysis during the first year and/or a hypercalcemia during the first 24 months; the search for a correlation between these parameters of bony resorption and known prognostic factors, has proven negative except for calcemia and the level of beta 2 serum microglobulins. This fact emphasizes the advantage of a treatment toward osteoclasts associated with the classic chemotherapy of multiple myeloma.
D000328:Adult; D000368:Aged; D001862:Bone Resorption / Q000473:pathology; D001842:Bone and Bones / Q000473:pathology*; D004406:Dysgammaglobulinemia / Q000473:pathology*; D005260:Female; D006801:Humans; D017098:IgA Deficiency; D017099:IgG Deficiency; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000473:pathology*; D011379:Prognosis
L'histomorphométrie osseuse dans les dysglobulinémies monoclonales. Intérêt diagnostique et pronostique.