Bone density declines over three years in prospective myelodysplastic neoplasm study

The prospective longitudinal BoHemE study, published in Leukemia, assessed bone health in 111 patients older than 60 years with myelodysplastic neoplasms (MDS) and 84 age-matched controls at two German university hospitals. Controls were undergoing hip replacement for osteoarthritis. Researchers measured bone mineral density by DXA and bone-related serum markers at baseline and after three years, alongside quality of life and survival outcomes.

At baseline, patients with MDS had T-scores 0.2 points lower than controls (p<0.05), a difference mainly attributed to women with MDS. Within the MDS cohort, DNMT3A mutations were associated with T-scores 0.7 points lower (p<0.05). Albumin-adjusted calcium and phosphate correlated with T-scores independently of age, sex, disease duration, IPSS-M score and transfusion dependence. Over three years, MDS T-scores declined by 0.3 points (p<0.05), while quality of life remained stable. Osteoporosis was associated with poorer overall survival (p<0.01), although the supplied text did not quantify the survival difference.

The authors recommend incorporating bone health assessment into MDS evaluation and management. These observational findings do not establish causation or show that osteoporosis treatment improves survival. Interpretation should also account for the selected osteoarthritis control population, differing female representation (36% versus 55%), and exclusion of patients receiving osteoporosis medications other than calcium or vitamin D.