{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T22:30:19Z","timestamp":1784759419582,"version":"3.55.0"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,6,27]],"date-time":"2017-06-27T00:00:00Z","timestamp":1498521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Pathological fractures are a common complication of plasma cell dyscrasias (<jats:styled-content style=\"fixed-case\">PCD<\/jats:styled-content>) and are associated with significant morbidity. Routine use of bisphosphonates over the past decade has aimed to reduce the risk of fractures in patients with multiple myeloma, but despite this, fractures continue to represent a significant burden of disease. In this study we report the fracture rate of hospital in\u2010patients with <jats:styled-content style=\"fixed-case\">PCD<\/jats:styled-content> in England. Data from the national registry Hospital Episode Statistics between 2001 and 2015 were used to determine fracture rate and its effect on overall survival. Fracture rates were 17\u00b78 times higher than the general population in the first year after admission with <jats:styled-content style=\"fixed-case\">PCD<\/jats:styled-content>, and remained elevated for up to 10\u00a0years after first admission. The increased fracture risk preceded the first admission with <jats:styled-content style=\"fixed-case\">PCD<\/jats:styled-content> and, conversely, the incidence of <jats:styled-content style=\"fixed-case\">PCD<\/jats:styled-content> increased after admission with one or more fractures. Overall survival is improving with <jats:styled-content style=\"fixed-case\">PCD<\/jats:styled-content>, however poorer survival is found in patients with a preceding fracture (Hazard ratio 1\u00b720). Despite widespread bisphosphonate use, fractures remain common in <jats:styled-content style=\"fixed-case\">PCD<\/jats:styled-content>, and are associated with poorer outcomes.<\/jats:p>","DOI":"10.1111\/bjh.14815","type":"journal-article","created":{"date-parts":[[2017,6,27]],"date-time":"2017-06-27T05:08:36Z","timestamp":1498540116000},"page":"61-65","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Increased fracture risk in plasma cell dyscrasias is associated with poorer overall survival"],"prefix":"10.1111","volume":"179","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4731-1784","authenticated-orcid":false,"given":"Graham","family":"McIlroy","sequence":"first","affiliation":[{"name":"Department of Renal Medicine University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jemma","family":"Mytton","sequence":"additional","affiliation":[{"name":"Department of Health Informatics University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicity","family":"Evison","sequence":"additional","affiliation":[{"name":"Department of Health Informatics University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Punit","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark T.","family":"Drayson","sequence":"additional","affiliation":[{"name":"Institute of Immunology and Immunotherapy College of Medical and Dental Sciences University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Cook","sequence":"additional","affiliation":[{"name":"Centre for Clinical Haematology University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6937-2852","authenticated-orcid":false,"given":"Guy","family":"Pratt","sequence":"additional","affiliation":[{"name":"Centre for Clinical Haematology University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Cockwell","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer H.","family":"Pinney","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,6,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.14-6-597"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602223340802"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdr054"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.2387"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14394"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2006.06269.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f2350"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0020124"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-04-282848"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.4065\/78.1.21"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-12-194241"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.0301212"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1359\/JBMR.041131"},{"key":"e_1_2_6_15_1","first-page":"CD003188","article-title":"Bisphosphonates in multiple myeloma: a network meta\u2010analysis","volume":"5","author":"Mhaskar R.","year":"2012","journal-title":"The Cochrane Database of Systematic Reviews"},{"key":"e_1_2_6_16_1","unstructured":"National Cancer Registration and Analysis Service(2016)Routes to Diagnosis 2006\u20102013 workbook a. 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