Skeletal health in patients following allogeneic hematopoietic cell transplantation

Bone. 2022 May:158:115684. doi: 10.1016/j.bone.2020.115684. Epub 2020 Oct 10.

Abstract

Allogeneic hematopoietic cell transplantation (HCT) is a potentially curative approach for patients with certain hematological diseases, including several forms of lymphoma and leukemia. Besides several treatment-associated risks, transplanted patients are at an increased risk of developing osteoporosis. The underlying pathophysiology is complex and includes factors influenced directly by the disease as well as applied therapies like irradiation, chemotherapy and adjuvant immunosuppressive agents. In addition, patients are prone to secondary hypogonadism, and many patients will require long-term glucocorticoid therapy to mitigate graft-versus-host reactions. All these factors contribute to bone loss, but the individual risk profile may vary greatly. This review summarizes our knowledge on bone loss following allogenic HCT and provides screening and treatment recommendations.

Keywords: Allogenic hematopoietic cell transplantation; Bone loss; Osteoporosis.

Publication types

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

MeSH terms

  • Graft vs Host Disease* / etiology
  • Graft vs Host Disease* / prevention & control
  • Hematologic Diseases*
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Transplantation Conditioning / adverse effects
  • Transplantation, Homologous / adverse effects