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Post-Transplant Events

Bone mineral density in children with thalassaemia major: determining factors and effects of bone marrow transplantation

Bone Marrow Transplantation volume 36, pages 331–336 (2005)Cite this article

Summary:

Osteoporosis and osteopenia affect up to half of patients with thalassaemia major (TM). We investigate the effects of acquired factors and BMT on bone mineral density (BMD) in these patients. In all, 53 patients on regular transfusion (BT group) and 33 patients at 5.7±1.9 years post transplant (BMT group) were recruited. BMD was measured by dual energy X-ray absorptiometry. Serum concentrations of osteocalcin, bone-specific alkaline phosphatase (ALP), beta-crossLap and urinary cross-linking deoxypyridinoline (DPD) were measured by chemiluminescence and enzyme immunoassay, respectively. Severe BMD deficit (Z-score <−2.5) at spine and hip were noted in 62 and 35% of BT group. Serum osteocalcin (β=−0.463; P=0.006) was predictive of spine BMD, whereas age (β=−0.843; P=0.007) and urine DPD (β=−0.439; P=0.037) were associated with hip BMD in BT group. Among BMT patients, post transplant duration (β=0.450; P=0.009) and serum bone-specific ALP (β=−0.495; P=0.013) were associated with spine BMD. Severe BMD deficit was less common among BMT than BT patients (6 vs 35%; P=0.036). The mean (s.d.) osteocalcin levels in BMT and BT groups were 96.4 (72.7) μg/l and 68.9 (40.3) μg/l, respectively (P=0.037). In conclusion, severe BMD deficit is common in Chinese TM patients and BMT may reverse BMD deficit in these patients.

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Acknowledgements

We thank Iris HS Chan and Chung Yi Li for their technical assistance in measuring biochemical bone markers.

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Authors and Affiliations

  1. Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

    T F Leung, E C W Hung, C K Li, Y Chu, K W Chik, M M K Shing, V Lee & P M P Yuen

  2. Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

    C W K Lam

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  1. T F Leung
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  2. E C W Hung
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  7. M M K Shing
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  8. V Lee
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Correspondence to T F Leung.

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Leung, T., Hung, E., Lam, C. et al. Bone mineral density in children with thalassaemia major: determining factors and effects of bone marrow transplantation. Bone Marrow Transplant 36, 331–336 (2005). https://doi.org/10.1038/sj.bmt.1705053

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