TY - JOUR
T1 - Effects of Allogeneic Bone Marrow Transplantation on Recipient Bone Mineral Density
T2 - A Prospective Study
AU - Kashyap, Ashwin
AU - Kandeel, Fouad
AU - Yamauchi, Dave
AU - Palmer, Joycelynne M.
AU - Niland, Joyce C.
AU - Molina, Arturo
AU - Fung, Henry
AU - Bhatia, Ravi
AU - Krishnan, Amrita
AU - Nademanee, Auayporn
AU - O'Donnell, Margaret R.
AU - Parker, Pablo
AU - Rodriguez, Roberto
AU - Snyder, David
AU - Spielberger, Ricardo
AU - Stein, Anthony
AU - Nadler, Jerry
AU - Forman, Stephen J.
PY - 2000
Y1 - 2000
N2 - 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.
AB - 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.
KW - Bone marrow transplantation
KW - Bone mineral density
KW - Leukemia
KW - Lymphoma
KW - Radiation therapy
UR - http://www.scopus.com/inward/record.url?scp=0033654775&partnerID=8YFLogxK
U2 - 10.1016/S1083-8791(00)70061-9
DO - 10.1016/S1083-8791(00)70061-9
M3 - Article
C2 - 10905772
AN - SCOPUS:0033654775
SN - 1083-8791
VL - 6
SP - 344
EP - 351
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 3 A
ER -