High prevalence of early-onset osteopenia/osteoporosis after allogeneic stem cell transplantation and improvement after bisphosphonate therapy

S Yao, P L McCarthy, L M Dunford, D M Roy, K Brown, P Paplham, M Syta, D Lamonica, S Smiley, M Battiwalla, S Padmanabhan, T Hahn

Research output: Contribution to journalArticle

54 Scopus citations

Abstract

Osteopenia/osteoporosis (O/O) has been associated with allogeneic stem cell transplantation (alloSCT). We retrospectively reviewed 102 patients undergoing a first alloSCT from 2000 to 2005 at our center to evaluate the prevalence of O/O < or =6 and >6 months post-alloSCT. Fifty-six patients did not have a dual energy X-ray absorptiometry (DXA) scan following alloSCT. Approximately half (n=13/27) of those with a first DXA scan < or =6 months post-alloSCT had O/O and a similar rate (n=9/19) was seen in those with a first DXA scan >6 months. There were no significant differences in patient characteristics between the normal and O/O groups. The dual femur (DF) appeared to be more vulnerable to alloSCT-induced bone mineral density (BMD) loss than the lumbar spine (LS), regardless of screening time. O/O patients were treated with bisphosphonates and 41% had a repeat DXA scan post-treatment. No patient developed jaw osteonecrosis and significant BMD improvement was seen at the LS (mean BMD, 1.03+/-0.13 vs 1.08+/-0.12, P=0.004) but not the DF (mean BMD, 0.84+/-0.06 vs 0.85+/-0.08, P=0.29), indicating BMD loss at the DF is more resistant than the LS to antiresorptive therapy. Our results demonstrate that O/O is an early and late complication post-alloSCT and bisphosphonate treatment reverses BMD loss at the LS.

Original languageEnglish (US)
Pages (from-to)393-8
Number of pages6
JournalBone Marrow Transplantation
Volume41
Issue number4
DOIs
StatePublished - Feb 2008

Keywords

  • Adolescent
  • Adult
  • Bone Density
  • Bone Density Conservation Agents
  • Diphosphonates
  • Female
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Male
  • Middle Aged
  • Osteoporosis
  • Prevalence
  • Retrospective Studies
  • Transplantation Conditioning
  • Transplantation, Homologous
  • Journal Article

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