Biochemical markers of bone disease in asymptomatic early stage multiple myeloma. A study on their role in identifying high risk patients

A. Corso, L. Arcaini, S. Mangiacavalli, C. Astori, E. Orlandi, A. Lorenzi, F. Passamonti, C. Klersy, C. Pascutto, A. Canevari-Sciorati, M. Lazzarino

Research output: Contribution to journalArticle

Abstract

Background and Objectives. Skeletal involvement is typical of multiple myeloma (MM) and its occurrence increases with the progression of the disease. We performed a study to evaluate the clinical importance of osteocalcin (bone gla-protein, BGP) and bone alkaline phosphatase (b-AP) as indices of osteoblastic activity, and deoxypyridoline (DPD) as a marker of bone resorption. Design and Methods. Fifty-two MM patients, 39 patients with monoclonal gammopathy of undetermined significance (MGUS), and 30 normal controls entered the study. Of the 52 MM patients, 10 showed lytic lesions at standard X-rays and 42 did not; 21 were untreated and 31 had been treated with chemotherapy (combined with bisphophonates in 15). Of these last, 12 had progressive disease and 19 were in plateau phase. Results. DPD levels were higher in MM patients than in patients with MGUS or healthy controls (p=0.0001 and p=0.0008, respectively). No statistical differences were seen between patients with MGUS and healthy controls. BGP serum levels were significantly lower in MM patients than in MGUS patients (p=0.001) or healthy controls (p=0.001). b-AP was significantly higher in MGUS patients than in MM patients (p=0.04). Biochemical parameters were analyzed in a continuous fashion and after dichotomization into low and high values with respect to normal ones. Abnormal high values of DPD showed statistically significant correlations with presence of osteolysis (p=0.008), advanced stage (p=0.03) and abnormal β2-microglobulin (β2M) values (p=0.03), while DPD as a continuous variable correlated significantly only with the presence of osteolysis (p=0.02). In contrast, neither BGP nor b-AP showed statistical correlations with the presence of lytic lesions, or with other clinical or laboratory parameters. In 15 patients followed with serial controls, modifications of DPD levels reflected bone disease status well. Of the 42 patients without radiologic evidence of skeletal lesions, 15 had abnormal DPD values. Spinal magnetic resonance imaging (MRI) showed initial lytic lesions in 10 of them. Interpretation and Conclusions. Biochemical markers of bone metabolism are useful in evaluating and monitoring skeletal involvement in MM patients. They may help clinicians to identify: 1) from among patients without radiologic evidence of lytic lesions, those who deserve more accurate radiologic examinations (namely MRI); 2) from among asymptomatic patients, and in association with spinal MRI, those patients at higher risk of progression who might benefit from early treatment.

Original languageEnglish
Pages (from-to)394-398
Number of pages5
JournalHaematologica
Volume86
Issue number4
Publication statusPublished - 2001

Fingerprint

Bone Diseases
Multiple Myeloma
Biomarkers
Monoclonal Gammopathy of Undetermined Significance
Osteocalcin
Alkaline Phosphatase
Bone and Bones
Osteolysis
Magnetic Resonance Imaging
Bone Resorption

Keywords

  • Bone-specific alkaline phosphatase
  • Deoxypyridoline
  • Myeloma bone disease
  • Osteocalcin

ASJC Scopus subject areas

  • Hematology

Cite this

Biochemical markers of bone disease in asymptomatic early stage multiple myeloma. A study on their role in identifying high risk patients. / Corso, A.; Arcaini, L.; Mangiacavalli, S.; Astori, C.; Orlandi, E.; Lorenzi, A.; Passamonti, F.; Klersy, C.; Pascutto, C.; Canevari-Sciorati, A.; Lazzarino, M.

In: Haematologica, Vol. 86, No. 4, 2001, p. 394-398.

Research output: Contribution to journalArticle

@article{0d2abdee51f84eedbfd776d84135993c,
title = "Biochemical markers of bone disease in asymptomatic early stage multiple myeloma. A study on their role in identifying high risk patients",
abstract = "Background and Objectives. Skeletal involvement is typical of multiple myeloma (MM) and its occurrence increases with the progression of the disease. We performed a study to evaluate the clinical importance of osteocalcin (bone gla-protein, BGP) and bone alkaline phosphatase (b-AP) as indices of osteoblastic activity, and deoxypyridoline (DPD) as a marker of bone resorption. Design and Methods. Fifty-two MM patients, 39 patients with monoclonal gammopathy of undetermined significance (MGUS), and 30 normal controls entered the study. Of the 52 MM patients, 10 showed lytic lesions at standard X-rays and 42 did not; 21 were untreated and 31 had been treated with chemotherapy (combined with bisphophonates in 15). Of these last, 12 had progressive disease and 19 were in plateau phase. Results. DPD levels were higher in MM patients than in patients with MGUS or healthy controls (p=0.0001 and p=0.0008, respectively). No statistical differences were seen between patients with MGUS and healthy controls. BGP serum levels were significantly lower in MM patients than in MGUS patients (p=0.001) or healthy controls (p=0.001). b-AP was significantly higher in MGUS patients than in MM patients (p=0.04). Biochemical parameters were analyzed in a continuous fashion and after dichotomization into low and high values with respect to normal ones. Abnormal high values of DPD showed statistically significant correlations with presence of osteolysis (p=0.008), advanced stage (p=0.03) and abnormal β2-microglobulin (β2M) values (p=0.03), while DPD as a continuous variable correlated significantly only with the presence of osteolysis (p=0.02). In contrast, neither BGP nor b-AP showed statistical correlations with the presence of lytic lesions, or with other clinical or laboratory parameters. In 15 patients followed with serial controls, modifications of DPD levels reflected bone disease status well. Of the 42 patients without radiologic evidence of skeletal lesions, 15 had abnormal DPD values. Spinal magnetic resonance imaging (MRI) showed initial lytic lesions in 10 of them. Interpretation and Conclusions. Biochemical markers of bone metabolism are useful in evaluating and monitoring skeletal involvement in MM patients. They may help clinicians to identify: 1) from among patients without radiologic evidence of lytic lesions, those who deserve more accurate radiologic examinations (namely MRI); 2) from among asymptomatic patients, and in association with spinal MRI, those patients at higher risk of progression who might benefit from early treatment.",
keywords = "Bone-specific alkaline phosphatase, Deoxypyridoline, Myeloma bone disease, Osteocalcin",
author = "A. Corso and L. Arcaini and S. Mangiacavalli and C. Astori and E. Orlandi and A. Lorenzi and F. Passamonti and C. Klersy and C. Pascutto and A. Canevari-Sciorati and M. Lazzarino",
year = "2001",
language = "English",
volume = "86",
pages = "394--398",
journal = "Haematologica",
issn = "0390-6078",
publisher = "NLM (Medline)",
number = "4",

}

TY - JOUR

T1 - Biochemical markers of bone disease in asymptomatic early stage multiple myeloma. A study on their role in identifying high risk patients

AU - Corso, A.

AU - Arcaini, L.

AU - Mangiacavalli, S.

AU - Astori, C.

AU - Orlandi, E.

AU - Lorenzi, A.

AU - Passamonti, F.

AU - Klersy, C.

AU - Pascutto, C.

AU - Canevari-Sciorati, A.

AU - Lazzarino, M.

PY - 2001

Y1 - 2001

N2 - Background and Objectives. Skeletal involvement is typical of multiple myeloma (MM) and its occurrence increases with the progression of the disease. We performed a study to evaluate the clinical importance of osteocalcin (bone gla-protein, BGP) and bone alkaline phosphatase (b-AP) as indices of osteoblastic activity, and deoxypyridoline (DPD) as a marker of bone resorption. Design and Methods. Fifty-two MM patients, 39 patients with monoclonal gammopathy of undetermined significance (MGUS), and 30 normal controls entered the study. Of the 52 MM patients, 10 showed lytic lesions at standard X-rays and 42 did not; 21 were untreated and 31 had been treated with chemotherapy (combined with bisphophonates in 15). Of these last, 12 had progressive disease and 19 were in plateau phase. Results. DPD levels were higher in MM patients than in patients with MGUS or healthy controls (p=0.0001 and p=0.0008, respectively). No statistical differences were seen between patients with MGUS and healthy controls. BGP serum levels were significantly lower in MM patients than in MGUS patients (p=0.001) or healthy controls (p=0.001). b-AP was significantly higher in MGUS patients than in MM patients (p=0.04). Biochemical parameters were analyzed in a continuous fashion and after dichotomization into low and high values with respect to normal ones. Abnormal high values of DPD showed statistically significant correlations with presence of osteolysis (p=0.008), advanced stage (p=0.03) and abnormal β2-microglobulin (β2M) values (p=0.03), while DPD as a continuous variable correlated significantly only with the presence of osteolysis (p=0.02). In contrast, neither BGP nor b-AP showed statistical correlations with the presence of lytic lesions, or with other clinical or laboratory parameters. In 15 patients followed with serial controls, modifications of DPD levels reflected bone disease status well. Of the 42 patients without radiologic evidence of skeletal lesions, 15 had abnormal DPD values. Spinal magnetic resonance imaging (MRI) showed initial lytic lesions in 10 of them. Interpretation and Conclusions. Biochemical markers of bone metabolism are useful in evaluating and monitoring skeletal involvement in MM patients. They may help clinicians to identify: 1) from among patients without radiologic evidence of lytic lesions, those who deserve more accurate radiologic examinations (namely MRI); 2) from among asymptomatic patients, and in association with spinal MRI, those patients at higher risk of progression who might benefit from early treatment.

AB - Background and Objectives. Skeletal involvement is typical of multiple myeloma (MM) and its occurrence increases with the progression of the disease. We performed a study to evaluate the clinical importance of osteocalcin (bone gla-protein, BGP) and bone alkaline phosphatase (b-AP) as indices of osteoblastic activity, and deoxypyridoline (DPD) as a marker of bone resorption. Design and Methods. Fifty-two MM patients, 39 patients with monoclonal gammopathy of undetermined significance (MGUS), and 30 normal controls entered the study. Of the 52 MM patients, 10 showed lytic lesions at standard X-rays and 42 did not; 21 were untreated and 31 had been treated with chemotherapy (combined with bisphophonates in 15). Of these last, 12 had progressive disease and 19 were in plateau phase. Results. DPD levels were higher in MM patients than in patients with MGUS or healthy controls (p=0.0001 and p=0.0008, respectively). No statistical differences were seen between patients with MGUS and healthy controls. BGP serum levels were significantly lower in MM patients than in MGUS patients (p=0.001) or healthy controls (p=0.001). b-AP was significantly higher in MGUS patients than in MM patients (p=0.04). Biochemical parameters were analyzed in a continuous fashion and after dichotomization into low and high values with respect to normal ones. Abnormal high values of DPD showed statistically significant correlations with presence of osteolysis (p=0.008), advanced stage (p=0.03) and abnormal β2-microglobulin (β2M) values (p=0.03), while DPD as a continuous variable correlated significantly only with the presence of osteolysis (p=0.02). In contrast, neither BGP nor b-AP showed statistical correlations with the presence of lytic lesions, or with other clinical or laboratory parameters. In 15 patients followed with serial controls, modifications of DPD levels reflected bone disease status well. Of the 42 patients without radiologic evidence of skeletal lesions, 15 had abnormal DPD values. Spinal magnetic resonance imaging (MRI) showed initial lytic lesions in 10 of them. Interpretation and Conclusions. Biochemical markers of bone metabolism are useful in evaluating and monitoring skeletal involvement in MM patients. They may help clinicians to identify: 1) from among patients without radiologic evidence of lytic lesions, those who deserve more accurate radiologic examinations (namely MRI); 2) from among asymptomatic patients, and in association with spinal MRI, those patients at higher risk of progression who might benefit from early treatment.

KW - Bone-specific alkaline phosphatase

KW - Deoxypyridoline

KW - Myeloma bone disease

KW - Osteocalcin

UR - http://www.scopus.com/inward/record.url?scp=0035004937&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035004937&partnerID=8YFLogxK

M3 - Article

C2 - 11325645

AN - SCOPUS:0035004937

VL - 86

SP - 394

EP - 398

JO - Haematologica

JF - Haematologica

SN - 0390-6078

IS - 4

ER -