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Autologous stem cell transplantation normalizes abnormal bone remodeling and sRANKL/osteoprotegerin ratio in patients with multiple myeloma.
Terpos, E; Politou, M; Szydlo, R; Nadal, E; Avery, S; Olavarria, E; Kanfer, E; Goldman, J M; Apperley, J F; Rahemtulla, A.
Afiliação
  • Terpos E; Department of Hematology, Faculty of Medicine Imperial College London, Hammersmith Hospital, London, UK.
Leukemia ; 18(8): 1420-6, 2004 Aug.
Article em En | MEDLINE | ID: mdl-15215875
ABSTRACT
The osteoprotegerin (OPG)/receptor activator of NF-kappa B ligand (RANKL) system has a major role in the pathogenesis of bone disease in myeloma (MM). The effect of autologous stem cell transplantation (ASCT) on bone turnover in MM was evaluated in 51 patients (35M/16F). Markers of bone resorption (NTX, TRACP-5b), bone formation (bone-alkaline phosphatase (bALP), osteocalcin), OPG and sRANKL were measured pre- and every month post-ASCT. The median follow-up period was 12 months. Four patients were transplanted in CR, 44 were transplanted in PR and three patients had progressive/resistant disease. All patients received bisphosphonates both pre- and post-ASCT. At baseline the majority of patients had increased NTX, TRACP-5b levels, and sRANKL/OPG ratio, while markers of bone formation were strongly suppressed. ASCT produced a significant reduction of sRANKL/OPG ratio, with a concomitant decrease of NTX, and TRACP-5b levels, starting the second month post-ASCT. Bone formation markers, osteocalcin and bALP, started to increase after the 9th and 11th month post-ASCT, respectively, while the increase of OPG preceded this. These results provide biochemical evidence that ASCT normalizes the abnormal bone resorption in MM patients possibly through the decrease of RANKL/OPG ratio, while bone formation requires a longer period to return to normal.
Assuntos
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Bases de dados: MEDLINE Assunto principal: Remodelação Óssea / Transplante de Células-Tronco Hematopoéticas / Mieloma Múltiplo Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Leukemia Assunto da revista: HEMATOLOGIA / NEOPLASIAS Ano de publicação: 2004 Tipo de documento: Article País de afiliação: Reino Unido
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Bases de dados: MEDLINE Assunto principal: Remodelação Óssea / Transplante de Células-Tronco Hematopoéticas / Mieloma Múltiplo Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Leukemia Assunto da revista: HEMATOLOGIA / NEOPLASIAS Ano de publicação: 2004 Tipo de documento: Article País de afiliação: Reino Unido