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Monoclonal gammopathy of undetermined significance and risk of skeletal fractures: a population-based study

Kristinsson, Sigurdur Y.; Tang, Min; Pfeiffer, Ruth M.; Bjorkholm, Magnus; Blimark, Cecilie; Mellqvist, Ulf-Henrik; Wahlin, Anders; Turesson, Ingemar LU and Landgren, Ola (2010) In Blood 116(15). p.2651-2655
Abstract
Patients with multiple myeloma (MM) have an increased risk of fractures. On the basis of small numbers, patients with monoclonal gammopathy of undetermined significance (MGUS) have been reported to have an increased fracture risk. Using population-based data from Sweden, we assessed the risks of fractures in 5326 MGUS patients diagnosed from 1958 to 2006, compared with 20 161 matched controls. MGUS patients had an increased risk of any fracture at 5 (hazard ratio [HR] = 1.74; 95% confidence interval [CI], 1.58-1.92) and 10 (HR = 1.61; 95% CI, 1.49-1.74) years. The risk was significantly higher for axial (skull, vertebral/pelvis, and sternum/costae) compared with distal (arm and leg) fractures (P < .001). On the basis of 10 years of... (More)
Patients with multiple myeloma (MM) have an increased risk of fractures. On the basis of small numbers, patients with monoclonal gammopathy of undetermined significance (MGUS) have been reported to have an increased fracture risk. Using population-based data from Sweden, we assessed the risks of fractures in 5326 MGUS patients diagnosed from 1958 to 2006, compared with 20 161 matched controls. MGUS patients had an increased risk of any fracture at 5 (hazard ratio [HR] = 1.74; 95% confidence interval [CI], 1.58-1.92) and 10 (HR = 1.61; 95% CI, 1.49-1.74) years. The risk was significantly higher for axial (skull, vertebral/pelvis, and sternum/costae) compared with distal (arm and leg) fractures (P < .001). On the basis of 10 years of follow-up, there was an increased risk of vertebral/pelvic (HR = 2.37; 95% CI, 2.02-2.78), sternal/costae (HR = 1.93; 95% CI, 1.5-2.48), arm (HR = 1.23; 95% CI, 1.06-1.43), leg (HR = 1.40; 95% CI, 1.26-1.56), and other/multiple fractures (HR = 4.25; 95% CI, 3.29-5.51). Risks for fractures did not differ by isotype or M protein concentration at diagnosis. MGUS patients with (versus without) fractures had no excess risk of MM or Waldenstrom macroglobulinemia. Our results suggest that bone alterations are present in early myelomagenesis. Our findings may have implications for the development of better prophylaxis for bone disease in MGUS, and they provide novel clues on pathogenesis of MM bone disease. (Blood. 2010;116(15):2651-2655) (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Blood
volume
116
issue
15
pages
2651 - 2655
publisher
American Society of Hematology
external identifiers
  • wos:000282956700011
  • scopus:77957960294
ISSN
1528-0020
DOI
10.1182/blood-2010-04-282848
language
English
LU publication?
yes
id
90d9fb82-4ac7-461e-84b2-1f2b126e93c3 (old id 1726227)
date added to LUP
2010-12-03 11:58:02
date last changed
2018-05-29 11:43:45
@article{90d9fb82-4ac7-461e-84b2-1f2b126e93c3,
  abstract     = {Patients with multiple myeloma (MM) have an increased risk of fractures. On the basis of small numbers, patients with monoclonal gammopathy of undetermined significance (MGUS) have been reported to have an increased fracture risk. Using population-based data from Sweden, we assessed the risks of fractures in 5326 MGUS patients diagnosed from 1958 to 2006, compared with 20 161 matched controls. MGUS patients had an increased risk of any fracture at 5 (hazard ratio [HR] = 1.74; 95% confidence interval [CI], 1.58-1.92) and 10 (HR = 1.61; 95% CI, 1.49-1.74) years. The risk was significantly higher for axial (skull, vertebral/pelvis, and sternum/costae) compared with distal (arm and leg) fractures (P &lt; .001). On the basis of 10 years of follow-up, there was an increased risk of vertebral/pelvic (HR = 2.37; 95% CI, 2.02-2.78), sternal/costae (HR = 1.93; 95% CI, 1.5-2.48), arm (HR = 1.23; 95% CI, 1.06-1.43), leg (HR = 1.40; 95% CI, 1.26-1.56), and other/multiple fractures (HR = 4.25; 95% CI, 3.29-5.51). Risks for fractures did not differ by isotype or M protein concentration at diagnosis. MGUS patients with (versus without) fractures had no excess risk of MM or Waldenstrom macroglobulinemia. Our results suggest that bone alterations are present in early myelomagenesis. Our findings may have implications for the development of better prophylaxis for bone disease in MGUS, and they provide novel clues on pathogenesis of MM bone disease. (Blood. 2010;116(15):2651-2655)},
  author       = {Kristinsson, Sigurdur Y. and Tang, Min and Pfeiffer, Ruth M. and Bjorkholm, Magnus and Blimark, Cecilie and Mellqvist, Ulf-Henrik and Wahlin, Anders and Turesson, Ingemar and Landgren, Ola},
  issn         = {1528-0020},
  language     = {eng},
  number       = {15},
  pages        = {2651--2655},
  publisher    = {American Society of Hematology},
  series       = {Blood},
  title        = {Monoclonal gammopathy of undetermined significance and risk of skeletal fractures: a population-based study},
  url          = {http://dx.doi.org/10.1182/blood-2010-04-282848},
  volume       = {116},
  year         = {2010},
}