Document Detail

Sequential analysis of biochemical markers of bone resorption and bone densitometry in multiple myeloma.
MedLine Citation:
PMID:  15136220     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: Bone lesions often occur in multiple myeloma (MM), but no tests have proven useful in identifying patients with increased risk. Bone marker assays and bone densitometry are non-invasive methods that can be used repeatedly at low cost. This study was performed to evaluate these methods in predicting bone events in MM patients. DESIGN AND METHODS: Thirty newly diagnosed MM patients were enrolled. Serum C-terminal telopeptide (ICTP) and urinary N-terminal telopeptide (NTx) of collagen I were measured for assessment of bone resorption, and serum C-terminal (PICP) and N-terminal (PINP) propeptides of procollagen I, bone-specific alkaline phosphatase, and osteocalcin were measured to estimate bone formation. Dual energy X-ray absorptiometry (DEXA) was used to assess bone mineral density (BMD) of the lumbar spine, hip, and whole body. Serum and urine samples were collected every 6 weeks, DEXA-scans performed every 3 months, and skeletal radiographs were done every 6 months as well as when indicated. RESULTS: Serum ICTP and urinary NTx were predictive of progressive bone events. Markers of bone formation, bone mineral density assessments, and M component measurements were less informative. In Cox analysis, ICTP showed the highest predictive value, but should be replaced with NTx in patients with nephropathy. Pretreatment low lumbar BMD was predictive of early vertebral fractures. INTERPRETATION AND CONCLUSIONS: Sequential DEXA-scans showed heterogeneous local BMD changes, and our data do not support routine use of sequential DEXA-scans. However, lumbar DEXA-scans at diagnosis can identify patients with increased risk of early vertebral collapses. Sequential analyses of serum ICTP and urinary NTx are useful for monitoring bone damage.
Niels Abildgaard; Kim Brixen; Erik Fink Eriksen; Jens Erik Kristensen; Johan Lanng Nielsen; Lene Heickendorff
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Haematologica     Volume:  89     ISSN:  1592-8721     ISO Abbreviation:  Haematologica     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-11     Completed Date:  2006-04-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0417435     Medline TA:  Haematologica     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  567-77     Citation Subset:  IM    
Department of Haematology, Aarhus University Hospital, Amtssygehuset, DK-8000 Aarhus C, Denmark.
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MeSH Terms
Absorptiometry, Photon
Aged, 80 and over
Bone Density / physiology*
Bone Resorption / metabolism*
Collagen / blood
Collagen Type I
Disease Progression
Middle Aged
Multiple Myeloma / drug therapy,  metabolism,  physiopathology*
Peptide Fragments / urine
Peptides / blood
Procollagen / urine
Tumor Markers, Biological / metabolism*
Reg. No./Substance:
0/Collagen Type I; 0/Peptide Fragments; 0/Peptides; 0/Procollagen; 0/Tumor Markers, Biological; 0/collagen type I trimeric cross-linked peptide; 0/procollagen type I carboxy terminal peptide; 9007-34-5/Collagen

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