Bone and hormonal status 10 years post-allogeneic bone marrow transplantation

Area of Science:

• Hematology
• Endocrinology
• Oncology

Background:

• Allogeneic stem cell transplant (allo-SCT) can lead to late complications like bone loss and endocrine dysfunction.
• Limited data exists on the long-term effects of allo-SCT in adult patients.

Purpose of the Study:

• To evaluate bone status (BMD) and endocrine functions in adult leukemia patients more than 10 years after allo-SCT.
• To assess the prevalence of low BMD, fractures, avascular necrosis, and hormonal imbalances.

Main Methods:

• Assessed bone mineral density (BMD) using Z scores.
• Measured parathyroid hormone (PTH), TSH, free T4, testosterone, SHBG, FSH, LH, and IGF-1 levels.
• Included 20 adult leukemia patients over 10 years post-allo-SCT.

Main Results:

• Two patients had low BMD (Z score <-2.0); two experienced osteoporotic fractures; two had avascular necrosis of the femoral head.
• Elevated PTH was found in 30% of patients, and 45% had low 25-hydroxy vitamin D (25(OH)D).
• Most thyroid tests were normal, but 8 of 12 males showed elevated FSH.

Conclusions:

• Adult leukemia patients generally maintain good BMD more than 10 years after allo-SCT.
• Individualized osteoporosis prophylaxis is necessary, with regular BMD monitoring.
• Monitoring PTH and vitamin D levels pre- and post-allo-SCT is recommended, with vitamin D supplementation considered. Male gonadal function requires further investigation.