Systemic Mastocytosis (SM), a clonal expansion of mast cells affecting multiple organs including the skeletal system, puts patients at risk of osteoporosis and fractures. Various aspects of skeletal disease in SM have been reported among European cohorts.
To determine fracture prevalence and risk predictors in SM in a North American (NA) cohort and compare findings with studies of other populations.
Fifty patients, from 25-74 years, were grouped based on fracture type and history. Data collected included laboratory findings and radiographic markers such as serum tryptase, bone turnover markers, dual energy x-ray absorptiometry (DXA) images, and Trabecular Bone Scores (TBS). Univariate and multivariate analyses of these findings were performed.
Fracture history was found in 74% of patients. Significantly different median age, BMI, DXA scores, and alkaline phosphatase levels were observed between fracture groups, consistent with French and Dutch studies. Significant findings included the difference in TBS among fracture groups, the association between alkaline phosphatase and fracture type and occurrence, and the model for predicting fracture risk based on DXA spine T-scores, alkaline phosphatase, and age (81.3% accuracy, 77.1% sensitivity).
Our findings in a NA cohort are in overall agreement with those reported in European studies of skeletal disease and fracture risk for individuals with SM. Additionally, we include an interactive calculator designed from a predictive model based on the NA cohort which may be utilized for improved screening for fracture risk.

Copyright © 2021. Published by Elsevier Inc.