Denise Johnsson Campos1, César Luiz Boguszewski2, Vaneuza Araujo Moreira Funke3, Carmem Maria Sales Bonfim3, Carolina Aguiar Moreira Kulak2, Ricardo Pasquini3, Victória Zeghbi Cochenski Borba2. 1. Bone Marrow Transplantation Unit, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil; Endocrine Division (SEMPR), Department of Internal Medicine, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil. Electronic address: Denisejca@gmai.com. 2. Endocrine Division (SEMPR), Department of Internal Medicine, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil. 3. Bone Marrow Transplantation Unit, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
Abstract
OBJECTIVE: The aim of the study was to evaluate the effect of allogeneic hematopoietic stem cell transplantation (HSCT) on bone mineral density (BMD), serum vitamin D levels, and nutritional status of 50 patients between ages 4 and 20 y. METHODS: We conducted pre-HSCT and 6-mo post-HSCT evaluations. We measured BMD at the lumbar spine (LS) and total body (TB) by dual energy x-ray absorptiometry (DXA); body composition by bioimpedance analysis, and dietary intakes of calcium and vitamin D using the 24-h recall and semiquantitative food frequency questionnaire methods. RESULTS: We observed a significant reduction in BMD 6 mo post-HSCT. Nearly half (48%) of patients had reductions at the LS (average -9.6% ± 6.0%), and patients who developed graft-versus-host disease (GVHD) had the greatest reductions (-5.6% versus 1.2%, P < 0.01). We also found reductions in serum levels of 25-hydroxyvitamin D (25-OHD), from 25.6 ± 10.9 ng/dL to 20.4 ± 11.4 ng/dL (P < 0.05), and in body weight. Corticosteroid treatment duration, severity of chronic GVHD, serum 25-OHD levels, and family history of osteoporosis were all risk factors associated with variations in BMD at the LS. CONCLUSION: HSCT in children and adolescents negatively effects their BMD, nutritional status, and vitamin D levels. We suggest that early routine assessment be done to permit prevention and treatment.
OBJECTIVE: The aim of the study was to evaluate the effect of allogeneic hematopoietic stem cell transplantation (HSCT) on bone mineral density (BMD), serum vitamin D levels, and nutritional status of 50 patients between ages 4 and 20 y. METHODS: We conducted pre-HSCT and 6-mo post-HSCT evaluations. We measured BMD at the lumbar spine (LS) and total body (TB) by dual energy x-ray absorptiometry (DXA); body composition by bioimpedance analysis, and dietary intakes of calcium and vitamin D using the 24-h recall and semiquantitative food frequency questionnaire methods. RESULTS: We observed a significant reduction in BMD 6 mo post-HSCT. Nearly half (48%) of patients had reductions at the LS (average -9.6% ± 6.0%), and patients who developed graft-versus-host disease (GVHD) had the greatest reductions (-5.6% versus 1.2%, P < 0.01). We also found reductions in serum levels of 25-hydroxyvitamin D (25-OHD), from 25.6 ± 10.9 ng/dL to 20.4 ± 11.4 ng/dL (P < 0.05), and in body weight. Corticosteroid treatment duration, severity of chronic GVHD, serum 25-OHD levels, and family history of osteoporosis were all risk factors associated with variations in BMD at the LS. CONCLUSION: HSCT in children and adolescents negatively effects their BMD, nutritional status, and vitamin D levels. We suggest that early routine assessment be done to permit prevention and treatment.
Authors: Filip Pirsl; Lauren M Curtis; Seth M Steinberg; Sri Harsha Tella; Mašenjka Katić; Marnie Dobbin; Jennifer Hsu; Fran T Hakim; Jacqueline W Mays; Annie P Im; Dražen Pulanić; Sandra A Mitchell; Judy Baruffaldi; Licia Masuch; David C Halverson; Ronald E Gress; Julianna Barsony; Steven Z Pavletic Journal: Biol Blood Marrow Transplant Date: 2016-04-23 Impact factor: 5.742
Authors: Gisele Trennepohl da Costa Heinen; Daniella Schmit; Denise Johnsson Campos; Carmem Bonfim; Estela Iraci Rabito; Regina Maria Vilela Journal: Support Care Cancer Date: 2017-10-03 Impact factor: 3.603
Authors: Alicia M Teagarden; Jodi L Skiles; Andrew L Beardsley; Michael J Hobson; Elizabeth A S Moser; Jamie L Renbarger; Courtney M Rowan Journal: Pediatr Transplant Date: 2017-07-02