Vitamin D deficiency does not alter biochemical markers of bone metabolism before or after autograft in patients with multiple myeloma

Abstract

So far, only one study has demonstrated a high incidence of vitamin D deficiency in patients with multiple myeloma. Vitamin D deficiency may alter bone remodelling in myeloma. In this study, we aimed to determine the prevalence of vitamin D deficiency and to assess its impact on bone remodelling and bone mineral density before and after autologous stem cell transplantation (ASCT). In 39 consecutive patients receiving high-dose chemotherapy (melphalan 200 mg/m(2)) followed by ASCT for multiple myeloma, we measured before (T0) and 12 months after ASCT (T12) serum calcium, 25-OH-D, PTH 1-84, bone alkaline phosphatase (bALP), serum C-terminal cross-linking telopeptide and lumbar spine bone mineral density (BMD). Mean vitamin D levels were low: 15 +/- 5 ng/mL (9-18) at T0 and 16 +/- 5 ng/mL (14-22) at T12. Twenty-six patients (68%) had vitamin D deficiency (25-OH-D < 20 ng/mL) at T0 and 58% at T12. Patients in the vitamin D-deficient group had higher serum PTH levels than those in the vitamin D-sufficient group : 71 +/- 24 pg/mL vs. 52 +/- 18 pg/mL (P = 0.04). Biochemical bone markers were identical in both groups at T0 and T12. Z-score values did not significantly differ between the two groups at T0 and T12. There were no correlations between 25-OH-D and BMD or bone marker levels. Vitamin D deficiency does not impair biochemical markers of bone metabolism in patients with multiple myeloma, before or after ASCT.