Effects of allogeneic bone marrow transplantation on recipient bone mineral density: A prospective study.

Academic Article

Abstract

  • Allogeneic bone marrow transplant (BMT) recipients have many known risk factors for developing decreased bone mineral density (BMD) after transplantation. We performed a prospective sequential evaluation of BMD in the lumbar spine and nondominant hip using dual-energy x-ray absorptiometry (DEXA) in a cohort of 47 adult patients (median age, 43 years) who were undergoing radiation-based BMT for hematologic malignancies. Baseline DEXA studies were performed before BMT and repeated at 3 to 4 months, 6 to 8 months, and 12 to 14 months after BMT. The majority of patients (60%) had been minimally treated with combination cytotoxic chemotherapy, having received no more than 1 treatment regimen before BMT. Graft-versus-host disease prophylaxis consisted of cyclosporine in combination with either methotrexate or prednisone, or both. Mean lumbar spine and hip BMD were normal before BMT (spine: 1.01 g/cm2, z score = 96%; hip: 0.86 g/cm2, z score = 100%) and gradually decreased (spine: 0.98 g/cm2, z score = 94%; hip: 0.76 g/cm2, z score = 91%) at 12 to 14 months. These declines were statistically significant (P < .006 and < .002 for lumbar spine; P < .001 and < .001 for hip). In addition, the sharpest decline occurred during the first 6 months after BMT and was more marked in the hip than the lumbar spine. These data suggest that BMT adversely affects BMD in this patient population.
  • Keywords

  • Absorptiometry, Photon, Adult, Antineoplastic Agents, Bone Density, Bone Diseases, Metabolic, Bone Marrow Transplantation, Bone and Bones, Cohort Studies, Combined Modality Therapy, Continental Population Groups, Female, Hematologic Neoplasms, Hip Joint, Humans, Lumbar Vertebrae, Male, Middle Aged, Minerals, Myelodysplastic Syndromes, Myeloproliferative Disorders, Osteoporosis, Prospective Studies, Risk Factors, Transplantation, Homologous
  • Author List

  • Kashyap A; Kandeel F; Yamauchi D; Palmer JM; Niland JC; Molina A; Fung H; Bhatia R; Krishnan A; Nademanee A
  • Start Page

  • 344
  • End Page

  • 351
  • Volume

  • 6
  • Issue

  • 3A