OBJECTIVES: To investigate bone involvement in a large cohort of systemic mastocytosis (SM) patients, and evaluate the efficacy of bisphosphonate therapy. PATIENTS AND METHODS: From 2000 to 2004, 75 patients with SM according to WHO criteria underwent skeletal x-rays and bone mineral density (BMD) assessment. Sequential BMD assessments were performed in nine patients treated with bisphosphonate (mean follow-up 65 months). RESULTS: 37 patients (49%) had bone involvement according to both x-rays and BMD evaluations: osteoporosis (23 patients, 31%, mean lumbar spine T score: -3 SD), with vertebral fracture (13 patients, 17%), axial skeleton osteosclerosis (six patients, 8%), mixed patterns (three patients), osteopenia with pre-existing fractures (four patients) and focal osteolytic lesion (one patient). Blood count abnormalities were associated with osteosclerosis (p=0.005). In nine patients with osteoporosis and bisphosphonate therapy, mean lumbar spine BMD increased from 0.83 to 0.92 g/cm(2) (+11.1%; ie, +2.05% per year) without recurrence of vertebral fracture. CONCLUSION: Half of adult patients with SM have bone involvement. Osteoporosis is the most prevalent bone manifestation in SM (31%). Bisphosphonate therapy seems efficient to improve lumbar spine BMD during SM-related osteoporosis. Spine x-ray and BMD should be performed in all SM patients to detect those who may benefit from anti-osteoporotic therapy.
OBJECTIVES: To investigate bone involvement in a large cohort of systemic mastocytosis (SM) patients, and evaluate the efficacy of bisphosphonate therapy. PATIENTS AND METHODS: From 2000 to 2004, 75 patients with SM according to WHO criteria underwent skeletal x-rays and bone mineral density (BMD) assessment. Sequential BMD assessments were performed in nine patients treated with bisphosphonate (mean follow-up 65 months). RESULTS: 37 patients (49%) had bone involvement according to both x-rays and BMD evaluations: osteoporosis (23 patients, 31%, mean lumbar spine T score: -3 SD), with vertebral fracture (13 patients, 17%), axial skeleton osteosclerosis (six patients, 8%), mixed patterns (three patients), osteopenia with pre-existing fractures (four patients) and focal osteolytic lesion (one patient). Blood count abnormalities were associated with osteosclerosis (p=0.005). In nine patients with osteoporosis and bisphosphonate therapy, mean lumbar spine BMD increased from 0.83 to 0.92 g/cm(2) (+11.1%; ie, +2.05% per year) without recurrence of vertebral fracture. CONCLUSION: Half of adult patients with SM have bone involvement. Osteoporosis is the most prevalent bone manifestation in SM (31%). Bisphosphonate therapy seems efficient to improve lumbar spine BMD during SM-related osteoporosis. Spine x-ray and BMD should be performed in all SM patients to detect those who may benefit from anti-osteoporotic therapy.
Authors: H Che; V Breuil; B Cortet; J Paccou; T Thomas; L Chapuis; F Debiais; N Mehsen-Cetre; R M Javier; S Loiseau Peres; C Roux; K Briot Journal: Osteoporos Int Date: 2018-12-05 Impact factor: 4.507
Authors: S Farmer; V V Shanbhogue; S Hansen; C I Stahlberg; H Vestergaard; A P Hermann; H Frederiksen Journal: Osteoporos Int Date: 2016-10-13 Impact factor: 4.507
Authors: S Seitz; F Barvencik; T Koehne; M Priemel; P Pogoda; J Semler; H Minne; M Pfeiffer; J Zustin; K Püschel; C Eulenburg; T Schinke; M Amling Journal: Osteoporos Int Date: 2013-02-23 Impact factor: 4.507
Authors: Peter Valent; Sabine Cerny-Reiterer; Gregor Hoermann; Wolfgang R Sperr; Leonhard Müllauer; Christine Mannhalter; Hubert Pehamberger Journal: Am J Blood Res Date: 2014-12-15
Authors: M Gehlen; A D Lazarescu; C Hinz; N Schmidt; M Pfeifer; M Werner; H F Weidemann; M Schwarz-Eywill; A Maier Journal: Z Rheumatol Date: 2016-09 Impact factor: 1.372