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.
|Title of host publication||Bone Disease of Organ Transplantation|
|Editors||Juliet Compston, Elizabeth Shane|
|Number of pages||13|
|Publication status||Published - 1 Dec 2005|