Abstract
Survival after allogeneic stem cell transplantation (allo-HSCT) has improved, but so have long-term sequelae. We studied risk factors for fractures and impaired bone health in allo-HSCT patients in the Basel HSCT registry from 01/2003 to 12/2014 using cox proportional models adjusted for age, gender and Karnofsky Index. Our primary endpoint was the incidence of fractures. Out of 652 patients, 32 (5.0%) had a new fracture after transplantation (yearly incidence rate of 1.6%, 95% Confidence Interval [95%CI] 1.1-2.3%) and 325 (49.8%) had low bone mineral density (yearly incidence rate of 13.1%, 95%CI 11.6-14.8%), including 36.0% with osteopenia and 13.8% with osteoporosis. We found vitamin D deficiency during follow-up (Hazard Ratio [HR] 1.25, 95%CI 1.11-1.41, p < 0.001), hyperthyroidism before transplantation (HR 4.85, 95%CI 1.05-22.54, p = 0.044), cumulative years of immunosuppressant exposure (HR 1.23, 95%CI 1.07-1.41, p = 0.004 for steroidal and HR 1.09, 95%CI 1.01-1.18, p = 0.025 for non-steroidal drugs) and graft-versus-host disease (acute HR 1.24, 95%CI 1.11-1.40, p < 0.001; chronic HR 2.82, 95%CI 1.12-7.13, p = 0.028) to be significantly associated with fractures. Patients undergoing HSCT are at increased risk of fractures...Continue Reading
References
May 18, 2000·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·A D SchimmerA Keating
Jun 13, 2001·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·J M SternD J Sherrard
Nov 22, 2001·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·N BuchsR Rizzoli
Jan 4, 2003·Blood·Gérard SociéUNKNOWN Late Effects Working Party of the European Study Group for Blood and Marrow Transplantation
Apr 29, 2003·British Journal of Haematology·Maher K GandhiJuliet E Compston
Nov 25, 2003·Blood·Claudia M S Schulte, Dietrich W Beelen
Oct 1, 1951·Irish Journal of Medical Science·M DANIELS
Mar 5, 2005·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·L Joseph MeltonS Vincent Rajkumar
Dec 13, 2005·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Alexandra H FilipovichMary E D Flowers
Apr 24, 2007·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Bipin N SavaniA John Barrett
Oct 4, 2007·The Journal of Clinical Endocrinology and Metabolism·Libuse TauchmanovàCarmine Selleri
Mar 4, 2008·Journal of Clinical Epidemiology·Erik von ElmUNKNOWN STROBE Initiative
Mar 2, 2010·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Song YaoTheresa Hahn
Mar 11, 2010·Transplantation·Anna D PetropoulouMarie Robin
May 22, 2010·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·J A KanisF Borgström
Aug 24, 2010·Bone Marrow Transplantation·B L McCluneN S Majhail
Sep 21, 2010·Haematologica·Alicia RovóAndré Tichelli
Jun 29, 2013·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Parameswaran HariLinda J Burns
Mar 18, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Xerxes N PundoleHuifang Lu
Feb 24, 2016·Bone Marrow Transplantation·J R PasswegM Mohty
Apr 5, 2016·Bone Marrow Transplantation·P AnandiM Battiwalla
Jan 24, 2017·Bone Marrow Transplantation·X PundoleH Lu
Apr 20, 2017·Oncotarget·Jiun-Nong LinJi-An Liang
Jun 20, 2017·Bone Marrow Transplantation·A GriggE Wong
Apr 6, 2018·Archives of Osteoporosis·Xerxes PundoleHuifang Lu
Citations
Apr 27, 2020·Bone Marrow Transplantation·Sanghee HongNavneet S Majhail
Nov 13, 2019·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Kripa Elizabeth CherianThomas V Paul
Jul 13, 2020·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Merav BarPaul A Carpenter
Aug 28, 2021·International Journal of Molecular Sciences·Massimo De MartinisSebastiano Gangemi
Sep 3, 2021·Transplantation and Cellular Therapy·Sarah SwaugerJonathan C Howell