Bisphosphonate therapy for reduced bone mineral density in children with chronic graft-versus-host disease
Bisphosphonate therapy for reduced bone mineral density in children with chronic graft-versus-host disease
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DOI：
10.1016/j.bbmt.2007.02.001
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发表时间：
2007-06-01
影响因子：
4.3
通讯作者：
Sanders, Jean E.
中科院分区：
文献类型：
--
作者：
Carpenter, Paul A.;Hoffmeister, Paul;Sanders, Jean E.
儿童在造血细胞移植(HCT)后经常会出现骨密度降低，但这种并发症的治疗方法尚不明确。为了确定双磷酸盐治疗对HCT后骨密度降低的影响，我们比较了48名接受钙和维生素D治疗的患者(对照组)和18名接受双磷酸盐治疗的患者的基线和随访双能X线骨密度仪(DEXA)扫描。在对照组中，标准化骨密度(SBMD)的中位数年化增长率为10%(范围为-26%至+41%)，但Z评分显示的sBMD与正常的偏差没有改善，与随访的-2.79(范围为-5.76至+0.07)相比，基线为-2.46(范围为-5.15至-1.16)。在接受双膦酸类药物治疗的患者中，sBMD的年化增幅中位数为33%(范围为3%至147%，P=.0002)，Z分数中位数从基线时的-3.57(范围为-5.13至-0.86)改善至随访时的-1.80(范围为-4.89至+0.47)(P=0.06)。对照组和双膦酸组的BMD Z评分的年化中位数变化分别为+0.12(-2.28至+4.24)和+1.43(-0.29至+3.72)(P=.0002)。在接受双磷酸盐治疗的儿童中，观察到骨密度改善最大。(C)2007年美国血液和骨髓移植学会。
Reduced bone mineral density (BMD) occurs frequently in children after hematopoietic cell transplantation (HCT), but therapy for this complication is undefined. To determine the impact of bisphosphonate therapy on reduced BMD after HCT, we compared baseline and follow-up dual energy X-ray absorptiometry (DEXA) scans of 48 patients (controls) who received calcium and vitamin D to 18 patients who also received bisphosphonate therapy. Among the controls, median annualized increase in standardized BMD (sBMD) was 10% (range, -26% to +41%), but the deviation of sBMD from normal, as indicated by the Z-score, did not improve from baseline, -2.46 (range: -5.15 to -1.16) compared to follow-up, -2.79 (range: -5.76 to +0.07). For the bisphosphonate-treated patients, the median annualized increase in sBMD was 33% (range 3% to 147%, P = .0002) and the median Z-score improved from -3.57 (range: -5.13 to -0.86) at baseline, to -1.80 (-4.89 to +0.47) at follow-up (P = .06). The annualized median change in BMD Z-scores per year was + 0.12 (-2.28 to +4.24) among the controls and + 1.43 (-0.29 to +3.72) for the bisphosphonate group (P = .0002). The greatest improvement in BMD was observed in children who received therapy with bisphosphonates. (C) 2007 American Society for Blood and Marrow Transplantation.