Bone remineralization of lytic lesions in multiple myeloma - The Arkansas experience.
Bone lytic lesion remineralization in high-risk myeloma patients
Journal
Bone
ISSN: 1873-2763
Titre abrégé: Bone
Pays: United States
ID NLM: 8504048
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
received:
12
11
2020
revised:
29
01
2021
accepted:
31
01
2021
pubmed:
9
2
2021
medline:
9
7
2021
entrez:
8
2
2021
Statut:
ppublish
Résumé
Multiple myeloma (MM) patients frequently present with extensive osteolytic bone lesions. However, the impact of myeloma treatment on focal lytic lesion remineralization has not been extensively studied. In this study, the effect of anti-myeloma treatment on the extent of bone remineralization was examined and potential mediators identified. Newly diagnosed MM patients enrolled in the Total Therapy 4 and 5 (TT4; n = 231, TT5; n = 64) protocols were longitudinally evaluated for changes in radiological parameters for a median of 6.1 years. Bone remineralization was defined as a sclerotic CT change within the lytic lesion and quantified as a percentage of remineralization, using the initial lesion size as a reference. Such changes were correlated to clinical and biochemical parameters, and the gene expression profile of bone marrow biopsy. Overall, remineralization occurred in 72% of patients (213/295). Of those patients that experienced remineralization, 36% (107/295) achieved at least 25% of bone remineralization. Patients with high-risk disease defined by gene expression profile signature (GEP70 ≥ 0.66) experienced significant remineralization compared to low-risk MM. Female patients were also more likely to experience bone remineralization and in a shorter median time (2.0 vs. 3.3 y). Factors such as serum alkaline phosphatase along with high levels of RUNX2 and SOX4 gene expression correlated with increasing extent of bone remineralization. This analysis demonstrated significant remineralization of lytic lesions in MM patients treated on TT clinical trials. While the underlying mechanism remains elusive these findings support the hypothesis that patient baseline bone-related factors play a fundamental role in the skeletal repair of bone lesions in MM that provide new opportunities for improving patient outcomes.
Identifiants
pubmed: 33556629
pii: S8756-3282(21)00038-7
doi: 10.1016/j.bone.2021.115876
pmc: PMC8627246
mid: NIHMS1750106
pii:
doi:
Substances chimiques
SOX4 protein, human
0
SOXC Transcription Factors
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
115876Subventions
Organisme : NIGMS NIH HHS
ID : P20 GM121293
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
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