Bone disease after bone marrow transplantation

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Abstract

Bone marrow transplantation (BMT) is used with increasing frequency and it outnumbers other forms of transplants. Bone marrow, or peripheral blood progenitor cell, transplantation is the choice of treatment for patients with certain hematological malignancies. Osteoporosis is more common after allo-BMT than auto-BMT and has a complex pathogenesis, related both to immunosuppressive therapy and effects on the stromal cell compartment of the bone marrow peculiar to BMT. A reduction in bone formation in the face of ongoing or increased bone resorption is a hallmark of this condition. Rapid and early bone loss, most severe at the femoral neck, is characteristic. The risk of osteoporosis, osteomalacia, fragility fractures, and avascular necrosis is increased. Contributing factors include cumulative glucocorticoid exposure, whether given before BMT or for the treatment of graft-versus-host disease (GVHD). Bone loss has also been related to the duration of CsA exposure and tacrolimus therapy, and it may also be a direct effect of GVHD itself on the bone cells.

Original languageEnglish
Title of host publicationBone Disease of Organ Transplantation
EditorsJuliet Compston, Elizabeth Shane
PublisherElsevier
Chapter19
Pages339-351
Number of pages13
ISBN (Print)9780121835026
DOIs
Publication statusPublished - 1 Dec 2005
Externally publishedYes

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