ABSTRACT
It has been demonstrated that adipocytes in the bone marrow have an inhibitory activity on
hematopoietic proliferation. This retrospective study attempts to establish if a correlation
exists between osteoporosis and hematopoiesis before and after adjuvant chemotherapy in the
context of breast cancer. Osteoporosis is interpreted both as a direct marker of osteoblastic
decline and as an indirect marker of increased bone marrow adiposity.
Patients from the “Centre du Sein” at CHUV (Centre Hospitalier Universitaire Vaudois)
undergoing adjuvant chemotherapy were included in this study. Evolution of blood counts
was studied in correlation with osteoporosis status. Toxicity of chemotherapy was coded
according to published probability of febrile neutropenia.
Results: 143 women were included; mean age 52.1 ± 12.5 years, mean BMI (body mass
index) 24.4 ± 4.1. BMD (bone mineral density) scored osteoporotic in 32% and osteopenic in
45%. Prior to chemotherapy BMD was positively correlated with neutrophil (p<0.001) and
thrombocyte (p=0.01) count; TBS (trabecular bone score) was not correlated with blood
count. After the first cycle of chemotherapy, an increase of one point in TBS correlated with
a decrease of 57% on the time to reach leucocyte nadir (p=0.004). There was a positive
correlation between BMD and risk of infection (p<0.001).
Our data demonstrates an association between osteoporosis and lower blood counts in a
younger cohort than previously published, extending it for the first time to neutrophil counts
in females. Our results suggest that the healthier the bone, the earlier the lowest leucocyte
count value, prompting further research on this area.