Guidance to Bone Morbidity in Children and Adolescents Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

Michaela Kuhlen; Marina Kunstreich; Riitta Niinimäki; Desiree Dunstheimer; Anita Lawitschka; Edit Bardi; André Willasch; Peter Bader; Wolfgang Högler; Christina Peters; Adriana Balduzzi

doi:10.1016/j.bbmt.2019.10.007

Guidance to Bone Morbidity in Children and Adolescents Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

Biol Blood Marrow Transplant. 2020 Feb;26(2):e27-e37. doi: 10.1016/j.bbmt.2019.10.007. Epub 2019 Oct 13.

Authors

Affiliations

¹ University Children's Hospital Augsburg, University Hospital Augsburg, Augsburg, Germany; Department of Pediatric Oncology, Hematology and Clinical Immunology, Center for Child and Adolescent Health, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. Electronic address: Michaela.Kuhlen@uk-augsburg.de.
² Department of Pediatric Oncology, Hematology and Clinical Immunology, Center for Child and Adolescent Health, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
³ Department of Children and Adolescents, Oulu University Hospital and University of Oulu, Oulu, Finland.
⁴ University Children's Hospital Augsburg, University Hospital Augsburg, Augsburg, Germany.
⁵ Department of Pediatrics, Medical University Vienna, St. Anna Children's Hospital, Vienna, Austria.
⁶ Department of Pediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria.
⁷ University Hospital Frankfurt/Main, Goethe University, Department for Children and Adolescents, Division for Stem Cell Transplantation and Immunology, Frankfurt/Main, Germany.
⁸ Clinica Pediatrica Università degli Studi di Milano Bicocca, Ospedale San Gerardo, Monza, Italy.

PMID: 31618689
DOI: 10.1016/j.bbmt.2019.10.007

Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is widely performed in children and adolescents with hematologic diseases, including very high-risk leukemia. With increasing success and survival rates, the long-term sequelae of HSCT have become important. Here, we provide guidance to the prevention and treatment of the most common bone morbidities-osteoporosis and osteonecrosis-emerging in the context of HSCT in children and adolescents. We give an overview on definitions, symptoms, and diagnostics and propose an algorithm for clinical practice based on discussions within the International Berlin Frankfurt Münster (BFM) Stem Cell Transplantation Committee and the Pediatric Disease Working Party of the European Society for Blood and Marrow Transplantation, our expert knowledge, and a literature review.

Keywords: Allogeneic HSCT; Bone morbidity; Children and adolescents; Leukemia.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Adolescent
Child
Hematopoietic Stem Cell Transplantation*
Humans
Leukemia*
Morbidity
Osteonecrosis* / etiology
Osteonecrosis* / therapy
Treatment Outcome