Increased fracture risk in plasma cell dyscrasias is associated with poorer overall survival

Graham McIlroy; Jemma Mytton; Felicity Evison; Punit Yadav; Mark T. Drayson; Mark Cook; Guy Pratt; Paul Cockwell; Jennifer H. Pinney

doi:10.1111/bjh.14815

Increased fracture risk in plasma cell dyscrasias is associated with poorer overall survival

Graham McIlroy^*, Jemma Mytton, Felicity Evison, Punit Yadav, Mark T. Drayson, Mark Cook, Guy Pratt, Paul Cockwell, Jennifer H. Pinney

^*Corresponding author for this work

Immunology and Immunotherapy

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

Pathological fractures are a common complication of plasma cell dyscrasias (PCD) and are associated with significant morbidity. Routine use of bisphosphonates over the past decade has aimed to reduce the risk of fractures in patients with multiple myeloma, but despite this, fractures continue to represent a significant burden of disease. In this study we report the fracture rate of hospital in-patients with PCD in England. Data from the national registry Hospital Episode Statistics between 2001 and 2015 were used to determine fracture rate and its effect on overall survival. Fracture rates were 17·8 times higher than the general population in the first year after admission with PCD, and remained elevated for up to 10 years after first admission. The increased fracture risk preceded the first admission with PCD and, conversely, the incidence of PCD increased after admission with one or more fractures. Overall survival is improving with PCD, however poorer survival is found in patients with a preceding fracture (Hazard ratio 1·20). Despite widespread bisphosphonate use, fractures remain common in PCD, and are associated with poorer outcomes.

Original language	English
Pages (from-to)	61-65
Number of pages	5
Journal	British Journal of Haematology
Volume	179
Issue number	1
DOIs	https://doi.org/10.1111/bjh.14815
Publication status	Published - Oct 2017

Bibliographical note

Funding Information:
GM and JP designed the research; GM, JM and FE acquired the data; GM and JM analysed and interpreted the data; PY, MD, MC, GP and PC contributed to the research design and data interpretation; All authors were involved in drafting and revising the paper; All authors approved of the final submitted version of the paper. This work received no funding. GM, JM, FE, PY, GP, PC and JP have no interests to declare. MD owns shares in Abingdon Health. MC has received research funding from Celgene and Janssen, and honoraria from Celgene, Janssen, Takeda and Amgen.

Publisher Copyright:
© 2017 John Wiley & Sons Ltd

Keywords

bone disease
myeloma
public health

ASJC Scopus subject areas

Hematology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/bjh.14815

Cite this

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title = "Increased fracture risk in plasma cell dyscrasias is associated with poorer overall survival",

abstract = "Pathological fractures are a common complication of plasma cell dyscrasias (PCD) and are associated with significant morbidity. Routine use of bisphosphonates over the past decade has aimed to reduce the risk of fractures in patients with multiple myeloma, but despite this, fractures continue to represent a significant burden of disease. In this study we report the fracture rate of hospital in-patients with PCD in England. Data from the national registry Hospital Episode Statistics between 2001 and 2015 were used to determine fracture rate and its effect on overall survival. Fracture rates were 17·8 times higher than the general population in the first year after admission with PCD, and remained elevated for up to 10 years after first admission. The increased fracture risk preceded the first admission with PCD and, conversely, the incidence of PCD increased after admission with one or more fractures. Overall survival is improving with PCD, however poorer survival is found in patients with a preceding fracture (Hazard ratio 1·20). Despite widespread bisphosphonate use, fractures remain common in PCD, and are associated with poorer outcomes.",

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author = "Graham McIlroy and Jemma Mytton and Felicity Evison and Punit Yadav and Drayson, {Mark T.} and Mark Cook and Guy Pratt and Paul Cockwell and Pinney, {Jennifer H.}",

note = "Funding Information: GM and JP designed the research; GM, JM and FE acquired the data; GM and JM analysed and interpreted the data; PY, MD, MC, GP and PC contributed to the research design and data interpretation; All authors were involved in drafting and revising the paper; All authors approved of the final submitted version of the paper. This work received no funding. GM, JM, FE, PY, GP, PC and JP have no interests to declare. MD owns shares in Abingdon Health. MC has received research funding from Celgene and Janssen, and honoraria from Celgene, Janssen, Takeda and Amgen. Publisher Copyright: {\textcopyright} 2017 John Wiley & Sons Ltd",

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AU - Mytton, Jemma

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AU - Drayson, Mark T.

AU - Cook, Mark

AU - Pratt, Guy

AU - Cockwell, Paul

AU - Pinney, Jennifer H.

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N2 - Pathological fractures are a common complication of plasma cell dyscrasias (PCD) and are associated with significant morbidity. Routine use of bisphosphonates over the past decade has aimed to reduce the risk of fractures in patients with multiple myeloma, but despite this, fractures continue to represent a significant burden of disease. In this study we report the fracture rate of hospital in-patients with PCD in England. Data from the national registry Hospital Episode Statistics between 2001 and 2015 were used to determine fracture rate and its effect on overall survival. Fracture rates were 17·8 times higher than the general population in the first year after admission with PCD, and remained elevated for up to 10 years after first admission. The increased fracture risk preceded the first admission with PCD and, conversely, the incidence of PCD increased after admission with one or more fractures. Overall survival is improving with PCD, however poorer survival is found in patients with a preceding fracture (Hazard ratio 1·20). Despite widespread bisphosphonate use, fractures remain common in PCD, and are associated with poorer outcomes.

AB - Pathological fractures are a common complication of plasma cell dyscrasias (PCD) and are associated with significant morbidity. Routine use of bisphosphonates over the past decade has aimed to reduce the risk of fractures in patients with multiple myeloma, but despite this, fractures continue to represent a significant burden of disease. In this study we report the fracture rate of hospital in-patients with PCD in England. Data from the national registry Hospital Episode Statistics between 2001 and 2015 were used to determine fracture rate and its effect on overall survival. Fracture rates were 17·8 times higher than the general population in the first year after admission with PCD, and remained elevated for up to 10 years after first admission. The increased fracture risk preceded the first admission with PCD and, conversely, the incidence of PCD increased after admission with one or more fractures. Overall survival is improving with PCD, however poorer survival is found in patients with a preceding fracture (Hazard ratio 1·20). Despite widespread bisphosphonate use, fractures remain common in PCD, and are associated with poorer outcomes.

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Increased fracture risk in plasma cell dyscrasias is associated with poorer overall survival

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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