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Post-Transplant Events

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

Bone Marrow Transplantation volume 41, pages 393–398 (2008)Cite this article

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 ⩽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 ⩽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.

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Authors and Affiliations

  1. Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA

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

  2. Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA

    D Lamonica

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Yao, S., McCarthy, P., Dunford, L. et al. High prevalence of early-onset osteopenia/osteoporosis after allogeneic stem cell transplantation and improvement after bisphosphonate therapy. Bone Marrow Transplant 41, 393–398 (2008). https://doi.org/10.1038/sj.bmt.1705918

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