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HSCT among younger patients increased risk for adult bone deficits
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A young age at hematopoietic stem cell transplantation represented a significant risk factor for bone deficits in early adulthood, according to study results.
The findings suggest efforts to reduce bone loss should concentrate on this demographic.
Low bone mineral density (BMD) has been reported in recipients of pediatric hematopoietic stem cell transplantation (HSCT), but it is unclear whether patient age at transplantation plays a role, according to background information in the study.
Anna Petryk
“Children who were transplanted at a younger age would be expected to have a chance to regain BMD in a rapid period of bone acquisition during puberty and to have better BMD outcome than children transplanted at an older age,” Anna Petryk, MD, and colleagues from the department of pediatrics at the University of Minnesota wrote. “This uncertainty about long-term impact of HSCT on BMD in the youngest patients complicates the decision about initiating therapeutic interventions when low BMD is diagnosed.”
Researchers conducted the study to determine whether patients who underwent HSCT before aged 10 years exhibited different long-term BMD deficits compared with patients transplanted at an older age and sibling controls.
The analysis included 151 HSCT recipients with 92 healthy siblings.
Median age of HSCT recipients was 10.9 ± 6.4 years at the time of transplantation for hematologic malignancies and 24.7 years ± 8.6 years at the time of study. The median age of healthy sibling controls was 22.3 years ± 8 years at the time of study.
Researchers performed dual-energy X-ray absorptiometry to assess BMD z scores for total body BMD and lumbar spine BMD for all patients, as well as femoral neck BMD for patients aged at least 20 years at the time of study.
Results showed that, at an average 14 years after HSCT, patients younger than 10 years at the time of HSCT exhibited significantly lower total body BMD (by 0.5 standard deviation) and femoral neck BMD z scores (by 0.8 standard deviation) compared with sibling controls (lower total body BMD, P=.003; femoral neck BMD z scores, P=.0001) and patients older than 18 years at HSCT (lower total body BMD, P=.04; femoral neck BMD z scores, P=.004).
Disclosure: The researchers report no relevant financial disclosures.
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