Division of Endocrinology, University of Miami Miller School of Medicine, Miami, FL, United States.
Division of Endocrinology, Stanford University School of Medicine, Stanford, CA, United States.
Bone. 2019 Feb;119:65-70. doi: 10.1016/j.bone.2018.02.019. Epub 2018 Feb 21.
Under physiologic conditions hematopoiesis takes place in the bone marrow, and the skeleton provides the structural and supportive network necessary for normal hematopoiesis. Chronic disorders affecting hematopoiesis such as sickle cell anemia and thalassemia demonstrate striking skeletal phenotypes including bone loss and increased fracture risk. There is mounting evidence that anemia in older populations may also be associated with bone fragility. Given the interconnectedness of bone and hematopoietic cells, it is important to review the potential clinical implications and opportunities for therapeutic intervention. There are recognized associations between blood-borne and solid tissue malignancy and skeletal health, but our review will focus on non-malignant disease.
在生理条件下，造血发生在骨髓中，骨骼为正常造血提供必要的结构和支持网络。影响造血的慢性疾病，如镰状细胞贫血和地中海贫血，表现出明显的骨骼表型，包括骨质流失和骨折风险增加。越来越多的证据表明，老年人群的贫血也可能与骨脆弱有关。鉴于骨骼和造血细胞的相互联系，重要的是要回顾潜在的临床意义和治疗干预的机会。血液恶性肿瘤和实体组织恶性肿瘤与骨骼健康之间存在公认的关联，但我们的综述将重点关注非恶性疾病。
