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Published on: March 7, 2013
Quantitative ultrasound detects bone changes following bone marrow transplantation in pediatric subjects with
N Di Iorgi1, E Calandra, A Secco
1Department of Pediatrics, IRCCS G. Gaslini, University of Genoa, Largo G. Gaslini 5, 16147 Genoa, Italy. natasciadiiorgi@ospedale-gaslini.ge.it
Insights
Bone marrow transplantation (BMT) can affect bone health in children. Quantitative ultrasound (QUS) shows mild bone status changes up to 3 years post-BMT, particularly in malignant cases and those with GVHD.
Area of Science:
- Pediatric Hematology
- Bone Metabolism
- Transplantation Medicine
Background:
- Bone marrow transplantation (BMT) is linked to bone morbidity in pediatric patients.
- Assessing bone status is crucial for long-term health outcomes in survivors.
Purpose of the Study:
- To investigate bone status using quantitative ultrasound (QUS) in pediatric patients undergoing BMT.
- To track changes in bone parameters before and up to 3 years after BMT.
Main Methods:
- Phalangeal QUS measures (Ad-SoS, BTT) were taken in 40 pediatric hematological patients pre-BMT and at 6, 12, 24, and 36 months post-BMT.
- Bone parameters were analyzed as Z-scores against age-sex-matched controls.
Main Results:
- Bone parameters (Ad-SoS, BTT Z-scores) showed a trend towards reduction by 36 months post-BMT.
- Bone status remained stable initially, then decreased, particularly in malignant cases, pre-pubertal subjects, and those with acute graft-versus-host disease (GVHD).
Conclusions:
- QUS monitoring reveals mild bone status impairment in pediatric BMT survivors up to 36 months post-transplant.
- Malignant disease, pre-pubertal status, and acute GVHD are associated with greater bone changes.
Background:
Bone marrow transplantation (BMT) is associated with bone morbidity. We investigated bone status with quantitative ultrasound (QUS) in pediatric patients with hematological diseases prior to and up to 3 yr following BMT.
Methods:
Phalangeal QUS measures for amplitude- dependent speed of sound (Ad-SoS) and bone transmission time (BTT) were obtained in 40 hematological patients (25 with malignant, 15 with non-malignant disease; 9.7+/-4.9 yr) before BMT and 6, 12, 24, and 36 months after BMT. Bone parameters were expressed as Z-scores based on age-sex-matched normal controls.
Results:
Mean Ad-SoS and BTT Z-scores were normal before BMT and reduced at 36 months (analysis of variance: p=0.0542 and p=0.0233). Ad-SoS and BTT Z-scores remained relatively stable in the first 6 months after BMT and then progressively decreased reaching a plateau at 12-36 months. In non-malignant patients, BTT Z-score decreased at 6-12 months (p=0.029) and subsequently increased, while in malignant patients BTT Z-score showed a decrease at 12-24 months. Pre-pubertal subjects displayed a drop of BTT Z-Score values at both 12 (p=0.023) and 36 months after BMT (p=0.049), while BTT Z-score remained relatively unchanged in pubertal subjects. Early impairment of BTT Z-score was found in patients who suffered acute graft versus host disease (GVHD) compared to patients without this clinical condition; BTT Z-score was lower at 36 months (p=0.045).
Conclusions:
Longitudinal assessment by QUS of pediatric BMT survivors evidenced that bone status is mildly affected up to 36 months after BMT, mainly in malignant patients, in pre-pubertal subjects at BMT and in patients who suffered acute GVHD.
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