Quantitative ultrasound detects bone impairment after bone marrow transplantation in children and adolescents affected by hematological diseases

Abstract Purpose Bone marrow transplantation (BMT) recipients are at risk of bone mass impairment and skeletal morbidity. We investigated bone status with quantitative ultrasound (QUS) technique in children and adolescents with hematological diseases before and after BMT. Methods Phalangeal QUS meas...

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Bibliographic Details
Published in:Bone (New York, N.Y.) N.Y.), 2008-07, Vol.43 (1), p.177-182
Main Authors: Di Iorgi, Natascia, Muratori, Tiziana, Secco, Andrea, Napoli, Flavia, Fratangeli, Nadia, De Terlizzi, Francesca, Giorgiani, Giovanna, Locatelli, Franco, Maghnie, Mohamad
Format: Article
Language:English
Subjects:
Adolescent
Adolescents
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Avascular osteonecrosis
Biological and medical sciences
Bone and Bones - diagnostic imaging
Bone Diseases - diagnostic imaging
Bone Diseases - epidemiology
Bone Diseases - etiology
Bone fractures
Bone marrow transplantation (BMT)
Bone Marrow Transplantation - adverse effects
Bone marrow, stem cells transplantation. Graft versus host reaction
Child
Child, Preschool
Children
Chronic graft versus host disease (cGVHD)
Cohort Studies
Cross-Sectional Studies
Diseases of the osteoarticular system
Female
Fundamental and applied biological sciences. Psychology
Hematologic Neoplasms - surgery
Humans
Incidence
Male
Medical sciences
Orthopedics
Quantitative ultrasound (QUS)
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
Ultrasonography
Vertebrates: anatomy and physiology, studies on body, several organs or systems
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Summary:Abstract Purpose Bone marrow transplantation (BMT) recipients are at risk of bone mass impairment and skeletal morbidity. We investigated bone status with quantitative ultrasound (QUS) technique in children and adolescents with hematological diseases before and after BMT. Methods Phalangeal QUS measures for amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT) were obtained in 144 hematological patients (81M, 63F; 11.6 ± 5.2 years); forty two were evaluated before BMT and 102 after allogeneic or autologous BMT. Bone parameters were expressed as Z -scores based on age–sex-matched normal controls. Results Mean BTT Z -score was reduced in subjects after BMT compared to patients before BMT (M, − 0.35 ± 1.04 vs. 0.70 ± 1.11, P < 0.001; F, − 0.60 ± 1.23 vs. 0.23 ± 1.17, P < 0.05). Females and males with hormone deficiencies showed reduced BTT Z -scores when compared with subjects without hormone defects (M, − 0.52 ± 1.0 vs. 0.05 ± 1.17, P < 0.05; F, − 0.50 ± 1.27 vs. − 0.19 ± 1.26; P = 0.06). AD-SoS and BTT Z -scores were reduced in 15 subjects with fractures and/or avascular osteonecrosis compared to patients without bone events (− 1.52 ± 1.7 vs. − 0.41 ± 1.32 and − 0.85 ± 1.19 vs. − 0.10 ± 1.18; both P s < 0.05). Bone event cumulative incidence was 4 times greater in subjects who suffered from chronic GVHD. Conclusions Assessment of phalangeal QUS in young BMT survivors points towards impairment of bone status and endocrine dysfunction and chronic GVHD as risk factors of adverse bone events.
ISSN:8756-3282
1873-2763
DOI:10.1016/j.bone.2008.03.018