Bone growth factor may increase benign tumors but not malignant cancer

Date: Sep-10-2013Patients undergoing spinal fusion surgery with bone morphogenetic protein (BMP) appear to be at increased risk of benign tumors - but not cancers, reports a study in the September issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

BMP Linked to Increased Risk of Benign Tumors

Dr. Nandan Lad of Duke University Medical Center and colleagues analyzed the risk of cancers and benign tumors in nearly 4,700 patients receiving BMP as part of spinal fusion surgery. Bone morphogenetic protein is a growth factor that can promote new bone formation. It is FDA-approved for one specific type of spinal fusion surgery, but has become widely used "off-label" for other fusion procedures.

Contrary to previous smaller studies, patients receiving BMP as commonly used today, had no increase in systemic or malignant cancer risk, compared to a matched group undergoing spinal fusion without BMP. However, spinal fusion with BMP was associated with a higher risk of benign tumors: about 30% higher, after adjustment for other factors.

Although absolute risks were small, patients receiving BMP had a higher rate of benign tumors of the nervous system - especially of the tissues lining the spinal cord and brain (meninges). The increase in these soft tissue tumors may be related to the "large local dose" of BMP around the spine, the researchers suspect. The results of this large, independent, propensity-matched study suggest that the use of BMP in lumbar fusions is associated with a significantly higher rate of benign neoplasms, but not malignancies.

Cancer After Spinal Fusion: The Role of Bone Morphogenetic Protein, doi: 10.1227/NEU.0000000000000018

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