Vitamin D deficiency does not alter biochemical markers of bone metabolism before or after autograft in patients with multiple myeloma.
So far, only one study has demonstrated a high incidence of vitamin D deficiency in patients with multiple myeloma. Vitamin D deficiency may alter bone remodelling in myeloma. In this study, we aimed to determine the prevalence of vitamin D deficiency and to assess its impact on bone remodelling and bone mineral density before and after autologous stem cell transplantation (ASCT).


METHODS
In 39 consecutive patients receiving high-dose chemotherapy (melphalan 200 mg/m(2)) followed by ASCT for multiple myeloma, we measured before (T0) and 12 months after ASCT (T12) serum calcium, 25-OH-D, PTH 1-84, bone alkaline phosphatase (bALP), serum C-terminal cross-linking telopeptide and lumbar spine bone mineral density (BMD).


RESULTS
Mean vitamin D levels were low: 15 +/- 5 ng/mL (9-18) at T0 and 16 +/- 5 ng/mL (14-22) at T12. Twenty-six patients (68%) had vitamin D deficiency (25-OH-D < 20 ng/mL) at T0 and 58% at T12. Patients in the vitamin D-deficient group had higher serum PTH levels than those in the vitamin D-sufficient group : 71 +/- 24 pg/mL vs. 52 +/- 18 pg/mL (P = 0.04). Biochemical bone markers were identical in both groups at T0 and T12. Z-score values did not significantly differ between the two groups at T0 and T12. There were no correlations between 25-OH-D and BMD or bone marker levels.


CONCLUSIONS
Vitamin D deficiency does not impair biochemical markers of bone metabolism in patients with multiple myeloma, before or after ASCT.
Laroche
Michel
M
Rheumatology Department, Purpan University Hospital, Toulouse, France. laroche.m@chu-toulouse.fr
Lemaire
Olivia
O
Attal
Michel
M
D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D016723:Bone Remodeling; D002112:Calcifediol / Q000097:blood; D002118:Calcium / Q000097:blood; D024042:Collagen Type I; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000378:metabolism / Q000628:therapy*; D010281:Parathyroid Hormone / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides; D011347:Procollagen / Q000097:blood; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous; D014808:Vitamin D Deficiency / Q000150:complications* / Q000378:metabolism
D015415:Biomarkers; D024042:Collagen Type I; D010281:Parathyroid Hormone; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; D000469:Alkaline Phosphatase; D002112:Calcifediol; D002118:Calcium