Bone Health in Patients With Hematopoietic Disorders of Bone Marrow Origin: Systematic Review and Meta- Analysis

被引：44

作者：

Steer, Kieran ^{[1
,2
,6
]}

Stavnichuk, Mariya ^{[1
,3
]}

Morris, Martin ^{[4
]}

Komarova, Svetlana V. ^{[1
,3
,5
]}

机构：

[1] Shriners Hosp Children Canada, 1003 Decarie Blvd, Montreal, PQ H4A 0A9, Canada

[2] McGill Univ, Dept Pharmacol & Therapeut, Fac Med, Montreal, PQ, Canada

[3] McGill Univ, Dept Anat & Cell Biol, Fac Med, Montreal, PQ, Canada

[4] McGill Univ, Schulich Lib Phys Sci Life Sci & Engn, Montreal, PQ, Canada

[5] McGill Univ, Fac Dent, Montreal, PQ, Canada

[6] Univ Alberta, Fac Med, Edmonton, AB, Canada

来源：

JOURNAL OF BONE AND MINERAL RESEARCH | 2017年 / 32卷 / 04期

基金：

加拿大健康研究院;

关键词：

ANALYSIS; QUANTIFICATION OF BONE; BONE MARROW; CHRONIC MYELOPROLIFERATIVE DISORDERS; HEMOLYTIC ANEMIAS; TUMOR-INDUCED BONE DISEASE; X-RAY ABSORPTIOMETRY; MINERAL DENSITY; THALASSEMIA MAJOR; TRABECULAR BONE; ADIPOSE-TISSUE; YOUNG-ADULTS; OSTEOPOROSIS; CHILDREN; FRACTURES; TURNOVER;

D O I：

10.1002/jbmr.3026

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Blood cell production and bone homeostasis are physically interlinked systems that exhibit active cross-talk. We examined how bone health is affected in patients with hematopoietic disorders due to abnormal proliferation of bone marrow cells. The electronic databases Medline, Embase, PubMed, BIOSIS Previews, Web of Science, and Cochrane were searched for studies presenting numerical values for trabecular bone volume or bone mineral density in control and patients with hematopoietic disorders. We identified 5 studies for beta-thalassemia, 6 for sickle cell anemia, 2 for polycythemia vera and essential thrombocythemia, 3 for chronic myelogenous leukemia, 6 for myelofibrosis, 5 for multiple myeloma, and 4 studies each for systemic mastocytosis, lymphocytic leukemia, and hemochromatosis. The effect of the disease state on bone density was significant and negative for beta-thalassemia (r=-2.00; 95% confidence interval [CI] -3.41, -0.58; p<0.005), sickle cell anemia (-0.91; -1.36, -0.47; p<0.00005), chronic myelogenous leukemia (-0.55; -0.88, -0.22; p < 0005), mastocytosis (-0.99; -1.16, -0.82; p<0.00001), lymphoblastic leukemia (-0.69; -0.98, -0.40; p<0.00001), multiple myeloma (-0.67; -0.99, -0.35; p<0.00005), and hemochromatosis (-1.15; -1.64, -0.66; p < 0.00001). The changes were negative but not significant for polycythemia vera (-0.16; -0.38, 0.05; p=0.069) and essential thrombocythemia (-0.33; -0.92, 0.26; p=0.14). In myelofibrosis, disease state was associated with increased bone density (0.74; 0.12, 1.36; p<0.05). Bone density change significantly and negatively correlated with the level of ferritin and bone marrow cellularity but not with hemoglobin or erythropoietin. Thus, independent of hematopoietic lineage, abnormal proliferation of bone marrow cells appears to be associated with bone loss. Iron metabolism may independently contribute to bone homeostasis. (c) 2016 American Society for Bone and Mineral Research.

引用

页码：731 / 742

页数：12

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