Prospective assessment of bone turnover and clinical bone diseases after allogeneic hematopoietic stem-cell transplantation.
Transplantation
; 89(11): 1354-61, 2010 Jun 15.
Article
em En
| MEDLINE
| ID: mdl-20216480
ABSTRACT
BACKGROUND:
Bone complications after hematopoietic stem-cell transplantation (HSCT) are relatively frequent. Evaluation of biomarkers of bone turnover and dual energy x-ray absorptiometry (DEXA) are not known in this context.METHODS:
We prospectively evaluated bone mineral density, biomarkers of bone turnover, and the cumulative incidence of bone complications after allogeneic HSCT. One hundred forty-six patients were included. Bone mineral density was measured by DEXA 2-month and 1-year post-HSCT. The markers of bone turnover were serum C-telopeptide (C-TP), 5 tartrate-resistant acid phosphatase (bone resorption), and osteocalcin (bone formation) determined pre-HSCT and 2 months and 1 year thereafter. Potential association between osteoporosis at 2 months, osteoporotic fracture or avascular necrosis and, individual patient's characteristics and biologic markers were tested.RESULTS:
C-TP was high before and 2 months after transplant. At 2 months, DEXA detected osteoporosis in more than half the patients tested. Male sex, median age less than or equal to 15 years, and abnormal C-TP before HSCT were risk factors significantly associated with osteoporosis. Three-year cumulative incidences of fractures and avascular necrosis were 8% and 11%, respectively. Children were at higher risk of fracture, whereas corticosteroid treatment duration was a significant risk factor for developing a clinical bone complication post-HSCT. Bone complications and osteoporosis are frequent after HSCT. Bone biologic markers and DEXA showed that subclinical bone abnormalities appeared early post-HSCT.CONCLUSION:
The risk factors, age, gender, and C-TP easily available at the time of transplantation were identified. Biphosphonates should probably be given to patients with those risk factors.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transplante Homólogo
/
Osso e Ossos
/
Doenças Ósseas
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Transplante de Células-Tronco Hematopoéticas
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
Limite:
Adolescent
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Adult
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Child
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Female
/
Humans
/
Male
Idioma:
En
Revista:
Transplantation
Ano de publicação:
2010
Tipo de documento:
Article