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

Bone Marrow Transplant. 2012 May;47(5):657-62. doi: 10.1038/bmt.2011.147. Epub 2011 Jul 18.

Abstract

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.

MeSH terms

  • Absorptiometry, Photon
  • Adolescent
  • Adult
  • Bone Density*
  • Child
  • Child, Preschool
  • Female
  • Femur Neck / diagnostic imaging
  • Femur Neck / physiology
  • Fractures, Bone / etiology
  • Hip / diagnostic imaging
  • Hip / physiology
  • Human Growth Hormone / deficiency
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / physiology
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Risk
  • Stem Cell Transplantation / adverse effects*
  • Transplantation Conditioning
  • Vitamin D / analogs & derivatives*
  • Vitamin D / physiology
  • Vitamin D Deficiency / diagnostic imaging
  • Whole-Body Irradiation / adverse effects

Substances

  • Human Growth Hormone
  • Vitamin D
  • 25-hydroxyvitamin D