Blood cancer study links blood formation and bone health

Myelodysplastic syndromes (MDS) belong to the malignant diseases of the hematopoietic system that occur primarily in older adults. In patients with MDS, blood formation in bone marrow is impaired. Medical care therefore typically focuses on blood counts and the treatment of the resulting anemia and other changes in the blood profile; some patients also require regular blood transfusions. Until now, bone health has received less attention in cases of MDS.

The prospective study “Bone and Hematology in the Elderly” (BoHemE), initiated by researchers at Dresden University Hospital, now shows that people with MDS already had lower bone density than age-matched control subjects at the start of the study and continued to lose bone density over the course of three years. If osteoporosis was present at the start of the study, it was also associated with poorer overall survival. The study is published in the journal Leukemia.

“In patients with MDS, the bone-aging process seems to be sped up,” says professor Lorenz Hofbauer, explaining a key finding. He is the director of the University Center for Healthy Aging at Dresden University Hospital. Alongside professor Uwe Platzbecker, chief medical officer of Dresden University Hospital and a specialist in hematology and oncology, he initiated the recently published study in 2016. In addition to Dresden and Leipzig university hospitals, other national partners were involved.

A total of 111 patients with MDS and 84 age-matched control subjects were studied over a three-year period. The results confirmed that bone density was already lower in the patients at the start of the study and continued to decline over the observation period. In addition, the study provided evidence of complex relationships between blood formation and bone health: A specific mutation in the DNMT3A gene in blood-forming cells was associated with lower bone density. Moreover, individuals with low bone density or osteoporosis were also more frequently found to have low calcium levels.

“The results are crucial to our understanding of aging processes,” says Hofbauer. “MDS occurs primarily in elderly individuals, precisely during a phase of life in which bone mass, muscle strength and physical reserves also decline. Often, there is a chronic, subtle inflammatory process present without any apparent cause or infection. In addition, MDS is frequently associated with heart attacks and Alzheimer’s disease.”

“The message of the BoHemE study is clear: If you want to treat MDS comprehensively, you should also keep an eye on bone health,” says Hofbauer. “Strong bones, a high degree of mobility and a maintained quality of life are part of a healthy aging process and should be systematically taken into account during the diagnosis and ongoing management of MDS. The Osteoporosis Center at Dresden University Hospital provides suitable treatment options for the individualized management of bone diseases in MDS patients.”

The study opens up new avenues for future research, allowing scientists to investigate the biological relationships between hematopoiesis, aging processes and bone metabolism in greater detail. It thus exemplifies an approach based on systems medicine: The focus is not on a single finding or a single organ, but rather on the interplay between complex biological systems and clinical diseases.

Both research and the care of people with MDS can benefit from interdisciplinary collaboration among specialists in hematology, osteology, orthopedics, trauma surgery, computer science and evidence-based medicine. Particularly in older adults with complex conditions, such a comprehensive perspective can reveal new correlations.

In Germany, several thousand people are diagnosed with MDS each year, and the incidence rises significantly with age: While it is approximately four to five cases per 100,000 in the general population, it reaches rates of over 30 per 100,000 among those over 70 years of age. MDS is one of the most common malignant hematological diseases.

Provided by
Nationales Centrum für Tumorerkrankungen (NCT/UCC) Dresden

Who’s behind this story?

Gaby Clark

MA in English, copy editor since 2021 with experience in higher education and health content. Dedicated to trustworthy science news.

Full profile →

Robert Egan

Bachelor’s in mathematical biology, Master’s in creative writing. Well-traveled with unique perspectives on science and language.

Full profile →