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Review
. 2020 May 16;21(10):3538.
doi: 10.3390/ijms21103538.

Hematological Diseases and Osteoporosis

Agostino Gaudio  1 , Anastasia Xourafa  1 , Rosario Rapisarda  1 , Luca Zanoli  1 , Salvatore Santo Signorelli  1 , Pietro Castellino  1
Affiliations
Review

Hematological Diseases and Osteoporosis

Agostino Gaudio et al. Int J Mol Sci. .

Abstract

Secondary osteoporosis is a common clinical problem faced by bone specialists, with a higher frequency in men than in women. One of several causes of secondary osteoporosis is hematological disease. There are numerous hematological diseases that can have a deleterious impact on bone health. In the literature, there is an abundance of evidence of bone involvement in patients affected by multiple myeloma, systemic mastocytosis, thalassemia, and hemophilia; some skeletal disorders are also reported in sickle cell disease. Recently, monoclonal gammopathy of undetermined significance appears to increase fracture risk, predominantly in male subjects. The pathogenetic mechanisms responsible for these bone loss effects have not yet been completely clarified. Many soluble factors, in particular cytokines that regulate bone metabolism, appear to play an important role. An integrated approach to these hematological diseases, with the help of a bone specialist, could reduce the bone fracture rate and improve the quality of life of these patients.

Keywords: hemophilia; mastocytosis; monoclonal gammopathy of undetermined significance (MGUS); multiple myeloma; osteoporosis; thalassemia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Simplified pathogenesis of osteoporosis in multiple myeloma. MM: multiple myeloma cells; OC: osteoclast; OB: osteoblast; RANKL: receptor activator of NF-κB ligand; IL-1: interleukin-1; IL-6: interleukin-6; CCL3: chemokine C–C motif ligand 3; DKK-1: dickkopf-1.
Figure 2
Figure 2
Pathogenetic factors of TM-related osteoporosis. TM: Thalassemia Major.
Figure 3
Figure 3
Unbalanced bone turnover in hematological diseases. MGUS: monoclonal gammopathy of undetermined significance; RANKL: receptor activator of NF-κB ligand; OPG: osteoprotegerin.
See this image and copyright information in PMC

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