Accelerated bone mass senescence after hematopoietic stem cell transplantation

Autor: Bianca, Serio, Luca, Pezzullo, Raffaele, Fontana, Silvana, Annunziata, Rosa, Rosamilio, Maria Rosaria Sessa, Valentina Giudice, Idalucia, Ferrara, Monia, Rocco, Gennaro De Rosa, Patrizia, Ricci, Libuse, Tauchmanovà, Nunzia, Montuori, Carmine Selleri
Přispěvatelé: Serio, B, Pezzullo, L, Fontana, R, Annunziata, S, Rosamilio, R, Sessa, M, Giudice, V, Ferrara, I, Rocco, M, DE ROSA, Gennaro, Ricci, P, Tauchmanovà, L, Montuori, Nunzia, Selleri, C.
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Zdroj: Europe PubMed Central
Translational Medicine @ UniSa
Università degli studi di Salerno-IRIS
Popis: Osteoporosis and avascular necrosis (AVN) are long-lasting and debilitating complications of hematopoietic stem cell transplantation (HSCT). We describe the magnitude of bone loss, AVN and impairment in osteogenic cell compartment following autologous (auto) and allogeneic (allo) HSCT, through the retrospective bone damage revaluation of 100 (50 auto- and 50 allo-HSCT) long-term survivors up to 15 years after transplant. Current treatment options for the management of these complications are also outlined. We found that auto- and allo-HSCT recipients show accelerated bone mineral loss and micro-architectural deterioration during the first years after transplant. Bone mass density (BMD) at the lumbar spine, but not at the femur neck, may improve in some patients after HSCT, suggesting more prolonged bone damage in cortical bone. Phalangeal BMD values remained low for even more years, suggesting persistent bone micro-architectural alterations after transplant. The incidence of AVN was higher in allo-HSCT recipients compared to auto-HSCT recipients. Steroid treatment length, but not its cumulative dose was associated with a higher incidence of bone loss. Allo-HSCT recipients affected by chronic graft versus host disease seem to be at greater risk of continuous bone loss and AVN development. Reduced BMD and higher incidence of AVN was partly related to a reduced regenerating capacity of the normal marrow osteogenic cell compartment. Our results suggest that all patients after auto-HSCT and allo-HSCT should be evaluated for their bone status and treated with anti-resorptive therapy as soon as abnormalities are detected.
Databáze: OpenAIRE
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