Clinical Associations of Osteoporosis in BCR::ABL1 Negative Myeloproliferative Neoplasms

Osteoporosis can be seen in some hematologic diseases, such as BCR::ABL1-negative myeloproliferative neoplasms. The incidence and prevalence of osteoporosis and osteopenia in BCR::ABL1-negative MPN are not very well known.

Patients diagnosed with one of the classical BCR::ABL1-negative myeloproliferative neoplasms, such as essential thrombocythemia, polycythemia vera, and myelofibrosis, were included in the study. Due to the retrospective design, a matched control group was not available, and comparisons with the general population were made for contextual interpretation.

Ninety-four patients were included. Fifty-eight (61.7%) patients had osteopenia, and 16 (17%) patients had osteoporosis according to femoral dual energy X-ray absorptiometry (DXA) measurements. Fifty-three (58.9%) patients had osteopenia, and 27 (30%) patients had osteoporosis according to lumbar DXA measurements. When both femur and lumbar DXA measurements were evaluated together, 67 (71.3%) patients had osteopenia and 31 (33%) patients had osteoporosis. In patients over 50 years of age, these frequencies were found to be 71.4% for osteopenia and 37.7% for osteoporosis. Osteopenia was significantly associated with female sex, cytoreduction, and longer disease duration (p < 0.05). In the multivariate analysis, female sex was found to be an independent risk factor for osteopenia (p = 0.009, OR: 3.70, 95% CI: 1.394-9.833). Osteoporosis was significantly associated with disease subtype, female sex, age, and no antiaggregant use (p < 0.05). In the multivariate analysis, older age (p = 0.044, OR: 1.04, 95% CI: 1.001-1.083) was found to be an independent risk factor for osteoporosis.

Patients with BCR::ABL1-negative classical myeloproliferative neoplasms have a higher risk of osteopenia/osteoporosis compared to the general population. DXA measurements should be performed, especially in female patients and in patients of advanced age.