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Open Access 08-07-2024 | Graft-Versus-Host Disease | Original Article

Increased risk of hip and major osteoporotic fractures in 8463 patients who have undergone stem cell transplantation, a Swedish population-based study

Authors: Peter Johansson, Hallgerdur Lind Kristjansdottir, Helena Johansson, Dan Mellström, Catharina Lewerin

Published in: Osteoporosis International

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Abstract

Summary

In this retrospective cohort study of adult stem cell transplanted patients (n = 8463), a significant increased risk of both MOF and hip fractures was seen compared with the Swedish population and occurred in mean more than 2 years after stem cell transplantation.

Purpose

To explore the risk for osteoporotic fracture in patients who have undergone hematopoietic stem cell transplantation (HSCT) compared with the Swedish population.

Methods

The risk of osteoporotic fractures was determined in a retrospective population cohort study of adult (≥ 18 years) Swedish patients (n = 8463), who were transplanted with HSCT 1997–2016 and compared with all adults living in Sweden during the same period.

Results

In the total study group (n = 8463), 90 hip fractures (1.1% both in males and females) and 361 major osteoporotic fractures (MOF) (3.2% in men and 6.0% in women) were identified. In the total study population, the ratio of observed and expected number of hip fracture for women was 1.99 (95% CI 1.39–2.75) and for men 2.54 (95% CI 1.91–3.31). The corresponding ratio for MOF in women was 1.36 (CI 1.18–1.56) and for men 1.61 (CI 1.37–1.88). From 2005 onwards, when differentiation in the registry between allo- and auto-HSCT was possible, the observed number of hip fracture and MOF in allo-HSCT (n = 1865) were significantly increased (observed/expected hip fracture 5.24 (95% CI 3.28–7.93) and observed/expected MOF 2.08 (95% CI 1.63–2.62)). Fractures occurred in mean 2.7 (hip) and 2.5 (MOF) years after allo-HSCT. Graft-versus-host disease (GVHD) was not associated with an increased risk of fracture.

Conclusion

Patients who underwent HSCT had an increased risk of both hip and major osteoporotic fracture compared with the Swedish population and occurred in 4.3% of patients. GVHD was not statistically significantly associated with fracture risk.
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Metadata
Title
Increased risk of hip and major osteoporotic fractures in 8463 patients who have undergone stem cell transplantation, a Swedish population-based study
Authors
Peter Johansson
Hallgerdur Lind Kristjansdottir
Helena Johansson
Dan Mellström
Catharina Lewerin
Publication date
08-07-2024
Publisher
Springer London
Published in
Osteoporosis International
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-024-07171-9