Our data on the mRNA expression of RANK, RANKL, and OPG in BM cells of SM with osteoporosis/osteopenia suggest a complex regulation of bone metabolism but do not predictably implicate osteoclastogenesis since the ratio of RANKL/OPG mRNA was reduced in these patients compared to those without bone disease (Supplementary Fig. 8a), suggesting bone remodeling as others have reported using additional bone turnover markers2–4. Here, TNFRSF11A is linked to osteoporosis.