Evaluation of Bone Mineral Density and Fat‐Lean Distribution in Patients With Multiple Myeloma in Sustained Remission*

To study the usefulness of bone mineral density (BMD) in the follow‐up of myeloma (MM) patients, BMD was evaluated in 44 MM patients in sustained remission for at least 2 years (35.4 ± 10.5 months) after high‐dose or conventional chemotherapy in a retrospective study. Patients never received bisphosphonates before or during the follow‐up. Patients underwent lumbar spine (LS) BMD and a whole body (WB) BMD testing before therapy and at least once in the remission period. At baseline, mean LS BMD was 0.863 ± 0.026 g/cm2, mean lumbar Z‐score was −1.45 SD. LS BMD significantly increased from baseline by 5 ± 1.8%, 9.3 ± 1.7%, and 14 ± 1.9% at 1, 2, and 3 years, respectively. The percentage of patients with a T‐score below 2.5 SD decreased from 39% at baseline to 18.5% at 3 years. Compared with baseline, WB BMD decreased by −2.8 ± 0.5%, −2.6 ± 0.7%, and −1.7 ± 0.6% at 1, 2, and 3 years, respectively. Mean percentage change of the fat compartment increased from baseline by +28.4 ± 7.1% at the trunk, and + 17.1 ± 5% in peripheral areas at 3 years. In conclusion, in MM patients in remission after chemotherapy, LS BMD progressively increased after a mean follow‐up of 3 years. These patients never received bisphosphonates, so this increase was related to the anti‐myeloma treatment. The major effect on BMD was observed at the LS, which is primarily composed of trabecular bone containing the bone marrow. Interestingly, a drastic increase of the fat content was also observed. These results underlined that BMD and fat‐lean evaluation could be of interest in the follow‐up of MM patients.