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Updated: Jan 26, 2026
Isolation and Transplantation of Hematopoietic Stem Cells HSCs
Published on: February 25, 2007
Changes in trabecular bone score and bone mineral density following allogeneic hematopoietic stem cell
Yejee Lim1, Ki Hyun Baek2, Hee-Je Kim3
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea.
Insights
Bone mineral density (BMD) loss is significant after allogeneic hematopoietic stem cell transplantation (alloHSCT), particularly in cortical bone. Trabecular bone score (TBS) changes were insignificant over two years, indicating unique microarchitectural deficits post-transplant.
Area of Science:
- Bone biology and transplantation medicine
- Orthopedics and rheumatology
- Radiology and imaging analysis
Background:
- Allogeneic hematopoietic stem cell transplantation (alloHSCT) is associated with substantial bone mineral density (BMD) loss within the first year.
- This bone loss disproportionately affects cortical bone, suggesting unique underlying mechanisms.
- Characterizing structural bone deficits and microarchitecture changes post-alloHSCT is crucial.
Purpose of the Study:
- To evaluate changes in BMD and trabecular bone score (TBS) over two years in patients undergoing alloHSCT.
- To assess the microarchitectural integrity of bone following alloHSCT using TBS.
Main Methods:
- A retrospective study included adult patients who received alloHSCT.
- Two groups were analyzed: Group A (n=24) assessed BMD at baseline and 12 months post-transplant; Group B (n=44) assessed BMD at 12 and 24 months post-transplant.
- BMD and TBS were measured to track changes in bone structure and microarchitecture.
Main Results:
- Group A showed decreased BMD at the femoral neck and total hip by 12 months. Group B showed increased BMD at the lumbar spine and total hip between 12 and 24 months.
- TBS showed a non-significant decrease in Group A at 12 months and a non-significant increase in Group B at 24 months.
- Glucocorticoid dose correlated with BMD and TBS loss, while total body irradiation (TBI) dose negatively correlated with TBS.
Conclusions:
- Longitudinal analysis revealed microarchitectural changes in bone structure post-alloHSCT.
- While TBS changes were not statistically significant over two years, the data suggest disproportionate cortical bone loss.
- These findings highlight the complex impact of alloHSCT on bone health and microarchitecture.
Purpose:
It has been demonstrated that bone mineral density (BMD) loss is substantial within the first 12 months after allogeneic hematopoietic stem cell transplantation (alloHSCT). Declines in BMD showed a disproportionate cortical bone loss even though trabecular bone is metabolically more active than cortical bone. This finding suggests a unique mechanism. However, the structural bone deficits after alloHSCT have not been well characterized. The trabecular bone score (TBS) has emerged as a method to assess bone microarchitecture. The aim of this study was to evaluate the changes in BMD and TBS in patients who received alloHSCT with follow-up of two years.
Methods:
All patients 18 years and older who received alloHSCT between 2009 and 2015 at Seoul St. Mary's Hospital, Korea were included. They were segregated into a first group (A, n = 24) that was evaluated for BMD at the time of alloHSCT and 12 months posttransplant and a second group (B, n = 44) that was evaluated for BMD at 12 and 24 months following alloHSCT.
Results:
Subjects in group A experienced a decrease in BMD at the femoral neck and total hip between the time of transplantation and 12 months posttransplantation: 0.056 ± 0.057 (5.48%) and 0.072 ± 0.063 (6.84%), respectively. Subjects in group B experienced an increase in BMD at the lumbar spine and total hip between 12 and 24 months post-alloHSCT: 0.047 ± 0.064 (4.90%) and 0.017 ± 0.045 (2.16%), respectively. In group A, TBS at 12 months post-alloHSCT decreased 0.028 ± 0.067 (1.92%) from the baseline (p = 0.086). In group B, TBS at 24 months post-alloHSCT increased 0.010 ± 0.049 (0.78%) from the 12 months post-alloHSCT evaluation (p = 0.149). TBS change was positively associated with BMD changes at all measured sites. The cumulative dose of glucocorticoid therapy was associated with loss of BMD at all measured sites and TBS. In addition, the dose of total body irradiation (TBI) was negatively associated with TBS.
Conclusions:
In summary, this study delineated longitudinal microarchitectural changes in bone structure occurring in the context of alloHSCT. TBS change per 12 months was insignificant during the two years following alloHSCT. Therefore, our data represented disproportionate cortical bone loss in the context of the microarchitecture.
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