To The Editor:
We congratulate the authors of the excellent study "Recombinant Human BMP-2 and Allograft Compared with Autogenous Bone Graft for Reconstruction of Diaphyseal Tibial Fractures with Cortical Defects. A Randomized, Controlled Trial" (2006;88:1431-41), by Jones et al., which demonstrated that autograft is as safe and effective as allograft/BMP in the reconstruction of tibial cortical defects. Although safety has been shown in the short term and no incidents of long-term adverse effects have been reported, to our knowledge, concerns continue to be raised about an association of BMP with primary and secondary bone tumors1-3. Aberrations in BMP signaling have also been identified in various neoplasms3.
Locally applied BMPs are biologically active over only a short period of time, and bone is a tissue with very slow turnover. The risk of locally inducing a bone tumor may seem negligibly low. However, BMP is an unphysiological and aggressive stimulus, and the long-term implications of such treatment remain to be seen.
Because of the experience of the authors in treating patients with BMP, we pose the following questions to them:Have they seen any development of primary or secondary (bone) tumors in patients treated with BMP?Do they continue to follow patients for the onset of tumors after treatment with BMP?Is there a need for a comparative study regarding the prevalence of tumor-onset in patients treated with and without BMP?
Have they seen any development of primary or secondary (bone) tumors in patients treated with BMP?
Do they continue to follow patients for the onset of tumors after treatment with BMP?
Is there a need for a comparative study regarding the prevalence of tumor-onset in patients treated with and without BMP?