Bone remodelation markers are useful in the management of monoclonal gammopathies.
The evaluation of bone disease in multiple myeloma (MM) by conventional radiology has low reproducibility. In the last decade, several serum and urine biochemical parameters, for evaluation of bone turnover, have become available. The present study was designed to explore the value of six bone remodelation markers. It was studied in a series of 176 newly diagnosed patients with monoclonal gammopathies (107 MM and 69 monoclonal gammopathies of unknown significance (MGUS)). As control groups we used 25 patients with benign osteoporosis (BO) and 32 healthy individuals (HI). The bone markers analyzed included: bone resorption markers (BRM) (total pyridinoline, total deoxypyridinoline, free deoxypyridinoline and C-terminal telopeptide of collagen I) and bone formation markers (BFM) (bone alkaline phosphatase (bAP) and osteocalcin (OC)). Serum or urinary levels of BRM were significantly higher in MM patients than in MGUS patients, BO patients or HI (P < 0.001, respectively). BRM were higher in MM patients with lytic lesions. However, only C-terminal telopeptide discriminated MM patients without bone lesions from MGUS patients. BFM did not show significant differences in the aforementioned comparisons, although a trend toward higher values of OC and lower values of bAP in patients with early bone affectation was observed. Ratios BRM/BFM that contained bAP exhibited differences that were most significant between the MM group and other entities, as well as between the different MM subgroups. In fact, the ratios BRM/bAP provided discrimination between the MM subgroup without lyses and MGUS group (P < 0.01). BRM and BFM, especially the ratios, are useful in the evaluation of bone lesions in patients with monoclonal gammopathies.
Hernández
José M
JM
Department of Hematology, Hospital General of Segovia, Spain. jhernandez@hgse.sacyl.es
Suquía
Begoña
B
Queizan
José A
JA
Fisac
Rosa M
RM
Sanchez
José J
JJ
Fernández-Calvo
Francisco J
FJ
García-Sanz
Ramón
R
Olivier
Carmen
C
Bárez
Abelardo
A
Calmuntia
María J
MJ
García-Frade
Javier
J
Portero
Juan A
JA
López
Rosa
R
Aguilera
Carmen
C
Navajo
Jose A
JA
San-Miguel
Jesús F
JF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D014408:Biomarkers, Tumor / Q000097:blood / Q000652:urine; D016723:Bone Remodeling; D001862:Bone Resorption / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D015675:Osteocalcin / Q000097:blood / Q000652:urine; D010024:Osteoporosis / Q000097:blood / Q000175:diagnosis / Q000652:urine; D010265:Paraproteinemias / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D011237:Predictive Value of Tests; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies
D015415:Biomarkers; D014408:Biomarkers, Tumor; D015675:Osteocalcin; D000469:Alkaline Phosphatase