Decreased bone mineral density in young adults treated with SCT in childhood: the role of 25-hydroxyvitamin D

• Published in: Bone marrow transplantation (Basingstoke) Vol. 47; no. 5; pp. 657 - 662
• Main Authors: Frisk, P, Arvidson, J, Ljunggren, Ö, Gustafsson, J
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.05.2012; Nature Publishing Group
• Subjects: 25(OH) vitamin D; 25-Hydroxyvitamin D; Absorptiometry, Photon; Adolescent; Adult; Adults; Alfacalcidol; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Biomedical materials; Bone densitometry; Bone Density; Bone marrow; Bone marrow transplantation; Bone marrow, stem cells transplantation. Graft versus host reaction; Bone mass; Bone mineral density; Bones; Calcifediol; Calciferol; Cell Biology; Child; Child, Preschool; Children; Density; Dual energy X-ray absorptiometry; Female; Femur; Femur Neck - diagnostic imaging; Femur Neck - physiology; Fractures, Bone - etiology; Growth hormone; Growth hormones; Health aspects; Hematology; Hip; Hip - diagnostic imaging; Hip - physiology; Human Growth Hormone - deficiency; Humans; Hypogonadism; Internal Medicine; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - physiology; Male; Medical sciences; Medicine; Medicine & Public Health; Nutrient deficiency; original-article; Orthopaedic implants; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy; Public Health; Risk; SCT; Spine; Spine (lumbar); Stem cell transplantation; Stem Cell Transplantation - adverse effects; Stem Cells; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation Conditioning; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - physiology; Vitamin D Deficiency - diagnostic imaging; Vitamin deficiency; Whole-Body Irradiation - adverse effects; Young adults; Sweden; bone mineral density; dual-energy X-ray absorptiometry; growth hormone; SCT; 25(OH) vitamin D; Human; Radiodiagnosis; Hematology; Steroid hormone; Calcitriol; Exploration; X ray; Radiography; Somatotropin; Treatment; Adenohypophyseal hormone; Vitamin D; Dual energy absorptiometry; Young adult; Cholecalciferol(25-hydroxy); Bone mineral density; Child
• ISSN: 0268-3369; 1476-5365; 1476-5365
• DOI: 10.1038/bmt.2011.147

We measured bone mineral density (BMD) with dual-energy X-ray absorptiometry in the total body, at the lumbar spine, at the femoral neck and in the total hip, in 18 young adults with a median of 18.2 years after SCT. Fifteen patients had undergone auto-SCT and all patients had received TBI. The patients had significantly lower BMD in the total body, at the femoral neck, and in the total hip compared with age- and sex-matched controls. Six of 18 patients (33%) had low bone mass ( z -score <−1) at one or more measurement sites, as opposed to two of the controls (11%, P =0.29). We found no significant influence of growth hormone levels or of untreated hypogonadism on BMD variables. Levels of 25-hydroxy (25(OH)) vitamin D were lower among the patients (35.2 vs 48.8 nmol/L, P =0.044) and were significantly correlated with total body BMD in the patient group (r=0.55, P =0.021). All six patients with low bone mass had hypovitaminosis D (⩽37 nmol/L as opposed to 4 of the 11 (36%) patients without low bone mass ( P =0.035). In conclusion, we found decreased BMD in SCT survivors, which may in part be caused by 25(OH) vitamin D deficiency.