Bone mineral density and osteonecrosis in survivors of childhood allogeneic bone marrow transplantation
Bone mineral density and osteonecrosis in survivors of childhood allogeneic bone marrow transplantation
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DOI：
10.1038/sj.bmt.1704360
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发表时间：
2004-02-01
影响因子：
4.8
通讯作者：
Hale, GA
中科院分区：
文献类型：
--
作者：
Kaste, SC;Shidler, TJ;Hale, GA
我们的目的是评估儿科同种异体骨髓移植（alloBMT）幸存者的骨矿物质减少的频率和严重程度以及骨坏死的频率。我们回顾性回顾了 48 名患者的人口统计信息、治疗、磁共振 (MR) 成像研究（臀部和膝盖）以及通过定量计算机断层扫描 (QCT) 测量的骨矿物质密度 (BMD) 研究。总共 24 名患者为男性； 37 人是白人。 alloBMT 的中位年龄为 10.3 岁（1.6-20.4 岁）。 48 名患者中，43 名接受了 QCT。 alloBMT 和成像之间的中位时间为 5.1 年（1.0-10.2 年）。 BMD Z 得分中位数为 -0.89（-4.06 至 3.05）。 BMD Z 评分往往与女性性别相关（P=0.0559），但与 BMT 年龄、种族、初次诊断、alloBMT 时间、移植物 T 细胞耗竭、全身照射或急性/慢性移植物抗宿主病 (GVHD) 无关。 MR 显示 43 例中有 19 例发生骨坏死（44%）。我们发现骨坏死与性别、种族、诊断、BMT 年龄、GVHD 病史、BMT 时间或 T 细胞耗竭之间没有关联。 7 名患者 (15%) 出现骨坏死 MR 变化，BMD Z 评分小于 -1 s.d。我们的结论是，儿科同种异体骨髓移植幸存者的骨密度下降，并且有骨坏死的风险。应对其进行监测，以确保早期干预，从而改善不良后果。
Our purpose was to evaluate frequency and severity of bone mineral decrements and frequency of osteonecrosis in survivors of pediatric allogeneic bone marrow transplantation (alloBMT). We retrospectively reviewed demographic information, treatment, magnetic resonance (MR) imaging studies (hips and knees), and bone mineral density (BMD) studies of 48 patients as measured by quantitative computed tomography (QCT). In all, 24 patients were male; 37 were Caucasian. Median age at alloBMT was 10.3 years (1.6-20.4 years). Of the 48 patients, 43 underwent QCT. Median time between alloBMT and imaging was 5.1 years (1.0-10.2 years). Median BMD Z-score was -0.89 (-4.06 to 3.05). BMD Z-score tended to be associated with female sex (P=0.0559) but not with age at BMT, race, primary diagnosis, time from alloBMT, T-cell depletion of graft, total-body irradiation, or acute/chronic graft-versus-host disease (GVHD). MR showed osteonecrosis in 19 of 43 (44%). We found no associations between osteonecrosis and sex, race, diagnosis, age at BMT, history of GVHD, time from BMT, or T-cell depletion. Seven patients (15%) had MR changes of osteonecrosis and BMD Z-scores of less than -1 s.d. We conclude that pediatric alloBMT survivors have decreased BMD and are at risk of osteonecrosis. They should be monitored to assure early intervention that may ameliorate adverse outcomes.