Background: Chronic myeloid leukemia (CML) is one of the most commonly found types of myeloproliferative neoplasms, characterized by increased proliferation of granulocytic cells without losing their differentiation ability. Imatinib, a tyrosine kinase inhibitor (TKI), can be effectively used as therapy for CML. However, Imatinib can affect bone turnover thus having clinical implications on the bones of CML patients undergoing long-term Imatinib therapy. However, parameters that can accurately describe the bone condition in CML patients receiving Imatinib still need further study. A combination of imaging techniques such as bone mineral density (BMD) and bone turnover activity markers such as C-terminal telopeptide of type I collagen (CTX-1) and osteocalcin has the potential to be used as monitoring parameters for bone density abnormalities in CML patients receiving Imatinib. Objectives: This article explains the rationale for using BMD, CTX-1, and osteocalcin as monitoring parameters of bone remodeling in CML patients receiving Imatinib. Results: First, the physiological process of bone turnover will be explained. Then, we describe the role of tyrosine kinase in bone metabolism. Next, the impact of Imatinib on BMD, CTX-1, and osteocalcin will be explained. Conclusion: The assessment of bone health of CML patients on Imatinib should include both BMD tests and bone turnover marker assays such as CTX-1 and osteocalcin.

Introduction: Thalassemia is a rare hereditary condition that causes hemoglobin synthesis deficiency. Recurrent blood transfusion in transfusion-dependent thalassemia (TDT) individuals results in iron overload and deposition in body tissues, leading to endocrine malfunctions, including parathyroid. This study aimed to determine the correlation between the level of serum ferritin and parathyroid hormone level in TDT patients. Methods: A cross-sectional study was conducted among adult TDT patients receiving blood transfusions at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia from January to June 2023. Serum ferritin was measured using an enzyme-linked fluorescence assay (ELFA), while parathyroid hormone was quantified using an enzyme-linked immunosorbent assay (ELISA). The Spearman correlation analysis was used to identify the correlation between the level of serum ferritin with parathyroid hormone. Results: A total of 46 TDT patients were enrolled in the study, with a median age of 25 years old and represented predominantly by males (56.5%). The median levels of serum ferritin and parathyroid hormone were 5,672.90 ng/mL (min-max: 596.80–24,014.58 ng/mL) and 29.80 pg/mL (min-max: 10.61–97.01 pg/mL), respectively. The Spearman correlation analysis suggested a statistically insignificant negative correlation between serum ferritin and parathyroid hormone in TDT patients (r = -0.166; p=0.270). Conclusion: Serum ferritin was inversely, but not significantly, correlated with parathyroid hormone in TDT patients, suggesting that impaired parathyroid function might be associated with the increment of plasma iron.

Chronic Myeloid Leukemia (CML) is one of the most commonly found types of myeloproliferative neoplasms, characterized by increased proliferation of granulocytic cells without losing their differentiation ability. Imatinib, a Tyrosine Kinase Inhibitor (TKI), can be effectively used as therapy for CML. However, imatinib can affect bone turnover, thus having clinical implications on the bones of CML patients undergoing long-term imatinib therapy. However, parameters that can accurately describe the bone condition in CML patients receiving imatinib still need further study. A combination of imaging techniques such as Bone Mineral Density (BMD) and bone turnover activity markers such as C-terminal telopeptide of type I collagen (CTX-1) and Osteocalcin has the potential to be used as monitoring parameters for bone density abnormalities in CML patients receiving imatinib. This article explains the rationale for using BMD, CTX-1, and Osteocalcin as monitoring parameters of bone remodeling in CML patients receiving imatinib. First, the physiological process of bone turnover will be explained. Then, we describe the role of tyrosine kinase in bone metabolism. Next, the impact of imatinib on BMD, CTX-1, and Osteocalcin will be explained. In conclusion, the assessment of bone health of CML patients on Imatinib should include both BMD tests and bone turnover marker assays such as CTX-1 and Osteocalcin.