Metabolic bone diseases in patients after allogeneic hematopoietic stem cell transplantation: report from the Consensus Conference on Clinical Practice in chronic graft-versus-host disease

Transpl Int. 2011 Sep;24(9):867-79. doi: 10.1111/j.1432-2277.2011.01264.x. Epub 2011 May 9.

Abstract

With improved outcome of allogeneic stem cell transplantation (allo-SCT) for hematologic malignancies, long-term complications gain greater importance. Skeletal complications such as osteoporosis or avascular necrosis (AVN) occur frequently in allogeneic recipients with a cumulative incidence of diminished bone mineral density of 24-50% between 2 and 12 months after allo-SCT and a cumulative incidence of AVN in as many as 19% of patients 3 years after allo-SCT. Here, we present a review as part of the German, Austrian, and Swiss Consensus Conference on clinical practice in chronic graft-versus-host disease, held 2009 in Regensburg. The Consensus Conference aimed to achieve a consensus on the current evidence of diagnosis, prevention, and therapeutic options of late complications after allo-SCT summarizing and discussing the literature on these topics. In this report, we provide recommendations for metabolic bone diseases agreed upon by the working party. This includes guidelines for diagnosis, prevention, and therapeutic options in patients with low bone mass or AVN.

Publication types

  • Consensus Development Conference
  • Review

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Bone Density
  • Bone Diseases, Metabolic / etiology*
  • Bone Diseases, Metabolic / prevention & control
  • Bone Diseases, Metabolic / therapy
  • Calcium, Dietary / therapeutic use
  • Child
  • Denosumab
  • Diphosphonates / therapeutic use
  • Graft vs Host Disease* / complications
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hormone Replacement Therapy
  • Humans
  • Magnetic Resonance Imaging
  • Osteonecrosis / diagnosis
  • Osteonecrosis / etiology*
  • Osteoporosis / diagnosis
  • Osteoporosis / etiology*
  • Parathyroid Hormone / analogs & derivatives
  • Parathyroid Hormone / therapeutic use
  • RANK Ligand / therapeutic use
  • Risk Factors
  • Selective Estrogen Receptor Modulators / therapeutic use
  • Vitamin D / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Calcium, Dietary
  • Diphosphonates
  • Parathyroid Hormone
  • RANK Ligand
  • Selective Estrogen Receptor Modulators
  • Vitamin D
  • Denosumab