Denosumab treatment in aneurysmal bone cyst: Evaluation of nine cases

Background Aneurysmal bone cyst (ABC) is a benign bone tumor. Curettage and bone grafting is the common treatment. Here, we retrospectively evaluate nine patients treated with denosumab. Procedure Nine patients with ABC, mostly pelvic and vertebral, treated with denosumab were analyzed retrospective...

Full description

Saved in:
Bibliographic Details
Published in:Pediatric blood & cancer 2018-04, Vol.65 (4), p.n/a
Main Authors: Kurucu, Nilgun, Akyuz, Canan, Ergen, Fatma Bilge, Yalcin, Bilgehan, Kosemehmetoglu, Kemal, Ayvaz, Mehmet, Varan, Ali, Aydin, Burca, Kutluk, Tezer
Format: Article
Language:English
Subjects:
Aneurysm
aneurysmal bone cyst
benign bone tumors
Bone cancer
Bone grafts
Bone tumors
Curettage
Cysts
denosumab
Evaluation
Hematology
Hypercalcemia
Immunotherapy
Monoclonal antibodies
Morbidity
Oncology
Osteoclasts
Pain
Pediatrics
Spinal cancer
Substitute bone
Surgery
Targeted cancer therapy
Tumors
Vertebrae
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Aneurysmal bone cyst (ABC) is a benign bone tumor. Curettage and bone grafting is the common treatment. Here, we retrospectively evaluate nine patients treated with denosumab. Procedure Nine patients with ABC, mostly pelvic and vertebral, treated with denosumab were analyzed retrospectively. A 70 mg/m2 denosumab dose was used weekly in the first month, and then monthly. Clinical and radiological responses to treatment were evaluated. Results In all patients, clinical symptoms including pain and limping regressed completely within 3 months. Radiological evaluation revealed changes in lesion size and content. In six patients, overall volume reduction in the range of 18–82% was detected. Decreases in the size and number of cysts were detected in eight patients. In five patients, fat signal appeared on follow‐up imaging. No major side effects were observed during treatment. Median follow‐up time after treatment was 15 months. At 5 months, severe hypercalcemia was observed in two patients due to rebound increase in osteoclastic activity. Subsequent to denosumab treatment, three patients underwent surgery for clinical or radiological recurrence. Conclusions Our results showed that denosumab provided a meaningful clinical and radiological improvement in ABC. It may be a treatment option, especially in spinal and pelvic tumors with potentially high surgical morbidity. However, late rebound hypercalcemia may restrict its use. Studies with more cases are required for routine use of denosumab in ABC.
ISSN:1545-5009
1545-5017
DOI:10.1002/pbc.26926