Skip to main content
Top
Published in: Current Osteoporosis Reports 4/2013

01-12-2013 | Osteoporosis and Cancer (P Taxel, Section Editor)

Osteoporosis after Stem Cell Transplantation

Authors: Brian L. McClune, Navneet S. Majhail

Published in: Current Osteoporosis Reports | Issue 4/2013

Login to get access

Abstract

With long-term survival for recipients of autologous and allogeneic hematopoietic cell transplantation (HCT) increasing, the recognition of late complications such as decreased bone mineral density leading to osteoporosis (OP) has also increased. With an incidence that is reported to affect as many 50 % of allo HCT recipients, studies continue to mount supporting the need and success in treatment of this HCT complication. In this review, we highlight the major pathological mechanisms behind the development of OP, its diagnosis, and the literature supporting consensus treatment recommendations while noting areas of uncertainty that need further research.
Literature
1.
go back to reference Hahn T, McCarthy PL, Hasselbroek A, et al. Significant improvement in survival after allogeneic hematopoietic cell transplantation during a period of significantly increased use, older recipient age and use of unrelated donors. J Clin Oncol. 2013;31:2437–49.PubMedCrossRef Hahn T, McCarthy PL, Hasselbroek A, et al. Significant improvement in survival after allogeneic hematopoietic cell transplantation during a period of significantly increased use, older recipient age and use of unrelated donors. J Clin Oncol. 2013;31:2437–49.PubMedCrossRef
2.
go back to reference •• Lustberg MB, Reinbolt RE, Shapiro CL. Bone health in adult cancer survivorship. J Clin Oncol. 2013;30:3665–74. Good review of bone loss specifically related to the general oncology patient.CrossRef •• Lustberg MB, Reinbolt RE, Shapiro CL. Bone health in adult cancer survivorship. J Clin Oncol. 2013;30:3665–74. Good review of bone loss specifically related to the general oncology patient.CrossRef
3.
go back to reference Weilbaecher KN. Mechanisms of osteoporosis after hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2000;6:165–74.PubMedCrossRef Weilbaecher KN. Mechanisms of osteoporosis after hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2000;6:165–74.PubMedCrossRef
4.
go back to reference Hofbauer LC, Gori F, Riggs BL, et al. Stimulation of osteoprotegerin ligand and inhibition of osteoprotegerin production by glucocorticoids in human osteoblastic lineage cells: potential paracrine mechanisms of glucocorticoid-induced osteoporosis. Endocrinology. 1993;140:4382–9.CrossRef Hofbauer LC, Gori F, Riggs BL, et al. Stimulation of osteoprotegerin ligand and inhibition of osteoprotegerin production by glucocorticoids in human osteoblastic lineage cells: potential paracrine mechanisms of glucocorticoid-induced osteoporosis. Endocrinology. 1993;140:4382–9.CrossRef
5.
go back to reference Castelo-Branco C, Rovira M, Pons F, et al. The effect of hormone replacement therapy on bone mass in patients with ovarian failure due to bone marrow transplantation. Maturitas. 1996;23:307–12.PubMedCrossRef Castelo-Branco C, Rovira M, Pons F, et al. The effect of hormone replacement therapy on bone mass in patients with ovarian failure due to bone marrow transplantation. Maturitas. 1996;23:307–12.PubMedCrossRef
6.
go back to reference Syrjala KL, Langer SL, Abrams JR, et al. Late effects of hematopoietic cell transplantation among 10-year adult survivors compared with case-matched controls. J Clin Oncol. 2005;23:6596–606.PubMedCrossRef Syrjala KL, Langer SL, Abrams JR, et al. Late effects of hematopoietic cell transplantation among 10-year adult survivors compared with case-matched controls. J Clin Oncol. 2005;23:6596–606.PubMedCrossRef
7.
go back to reference Massenkeil G, Fiene C, Rosen O, et al. Loss of bone mass and vitamin D deficiency after hematopoietic stem cell transplantation: standard prophylactic measures fail to prevent osteoporosis. Leukemia. 2001;15:1701–5.PubMedCrossRef Massenkeil G, Fiene C, Rosen O, et al. Loss of bone mass and vitamin D deficiency after hematopoietic stem cell transplantation: standard prophylactic measures fail to prevent osteoporosis. Leukemia. 2001;15:1701–5.PubMedCrossRef
8.
go back to reference Robin M, Guardiola P, Devergie A, et al. A 10-year median follow-up study after allogeneic stem cell transplantation for chronic myeloid leukemia in chronic phase from HLA-identical sibling donors. Leukemia. 2005;19:1613–20.PubMedCrossRef Robin M, Guardiola P, Devergie A, et al. A 10-year median follow-up study after allogeneic stem cell transplantation for chronic myeloid leukemia in chronic phase from HLA-identical sibling donors. Leukemia. 2005;19:1613–20.PubMedCrossRef
9.
go back to reference Tauchmanova L, De Simone G, Musella T, et al. Effects of various antireabsorptive treatments on bone mineral density in hypogonadal young women after allogeneic stem cell transplantation. Bone Marrow Transplant. 2006;37:81–8.PubMed Tauchmanova L, De Simone G, Musella T, et al. Effects of various antireabsorptive treatments on bone mineral density in hypogonadal young women after allogeneic stem cell transplantation. Bone Marrow Transplant. 2006;37:81–8.PubMed
10.
go back to reference Kananen K, Volin L, Laitinen K, et al. Prevention of bone loss after allogeneic stem cell transplantation by calcium, vitamin D, and sex hormone replacement with or without pamidronate. J Clin Endocrinol Metab. 2005;90:3877–85.PubMedCrossRef Kananen K, Volin L, Laitinen K, et al. Prevention of bone loss after allogeneic stem cell transplantation by calcium, vitamin D, and sex hormone replacement with or without pamidronate. J Clin Endocrinol Metab. 2005;90:3877–85.PubMedCrossRef
11.
go back to reference Tauchmanova L, Selleri C, Esposito M, et al. Beneficial treatment with risedronate in long-term survivors after allogeneic stem cell transplantation for hematological malignancies. Osteoporos Int. 2003;14:1013–9.PubMedCrossRef Tauchmanova L, Selleri C, Esposito M, et al. Beneficial treatment with risedronate in long-term survivors after allogeneic stem cell transplantation for hematological malignancies. Osteoporos Int. 2003;14:1013–9.PubMedCrossRef
12.
go back to reference Valimaki MJ, Kinnunen K, Volin L, et al. A prospective study of bone loss and turnover after allogeneic bone marrow transplantation: effect of calcium supplementation with or without calcitonin. Bone Marrow Transplant. 1999;23:355–61.PubMedCrossRef Valimaki MJ, Kinnunen K, Volin L, et al. A prospective study of bone loss and turnover after allogeneic bone marrow transplantation: effect of calcium supplementation with or without calcitonin. Bone Marrow Transplant. 1999;23:355–61.PubMedCrossRef
13.
go back to reference Grigg AP, Shuttleworth P, Reynolds J, et al. Pamidronate reduces bone loss after allogeneic stem cell transplantation. J Clin Endocrinol Metab. 2006;91:3835–43.PubMedCrossRef Grigg AP, Shuttleworth P, Reynolds J, et al. Pamidronate reduces bone loss after allogeneic stem cell transplantation. J Clin Endocrinol Metab. 2006;91:3835–43.PubMedCrossRef
14.
go back to reference Yao S, Smiley SL, West K, et al. Accelerated bone mineral density loss occurs with similar incidence and severity, but with different risk factors, after autologous vs allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2010;16:1130–7.PubMedCrossRef Yao S, Smiley SL, West K, et al. Accelerated bone mineral density loss occurs with similar incidence and severity, but with different risk factors, after autologous vs allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2010;16:1130–7.PubMedCrossRef
15.
go back to reference Schulte CM, Beelen DW. Bone loss following hematopoietic stem cell transplantation: a long-term follow-up. Blood. 2004;103:3635–43.PubMedCrossRef Schulte CM, Beelen DW. Bone loss following hematopoietic stem cell transplantation: a long-term follow-up. Blood. 2004;103:3635–43.PubMedCrossRef
16.
go back to reference Tauchmanova L, Colao A, Lombardi G, et al. Bone loss and its management in long-term survivors from allogeneic stem cell transplantation. J Clin Endocrinol Metab. 2007;92:4536–45.PubMedCrossRef Tauchmanova L, Colao A, Lombardi G, et al. Bone loss and its management in long-term survivors from allogeneic stem cell transplantation. J Clin Endocrinol Metab. 2007;92:4536–45.PubMedCrossRef
17.
go back to reference Savani BN, Donohue T, Kozanas E, et al. Increased risk of bone loss without fracture risk in long-term survivors after allogeneic stem cell transplantation. Biol Blood Marrow Transplant. 2007;13:517–20.PubMedCrossRef Savani BN, Donohue T, Kozanas E, et al. Increased risk of bone loss without fracture risk in long-term survivors after allogeneic stem cell transplantation. Biol Blood Marrow Transplant. 2007;13:517–20.PubMedCrossRef
19.
go back to reference Nguyen ND, Eisman JA, Center JR, et al. Risk factors for fracture in nonosteoporotic men and women. J Clin Endocrinol Metab. 2007;92:955–62.PubMedCrossRef Nguyen ND, Eisman JA, Center JR, et al. Risk factors for fracture in nonosteoporotic men and women. J Clin Endocrinol Metab. 2007;92:955–62.PubMedCrossRef
20.
go back to reference Wainwright SA, Marshall LM, Ensrud KE, et al. Hip fracture in women without osteoporosis. J Clin Endocrinol Metab. 2005;90:2787–93.PubMedCrossRef Wainwright SA, Marshall LM, Ensrud KE, et al. Hip fracture in women without osteoporosis. J Clin Endocrinol Metab. 2005;90:2787–93.PubMedCrossRef
22.
go back to reference Body JJ, Bergmann P, Boonen S, et al. Management of cancer treatment-induced bone loss in early breast and prostate cancer: a consensus paper of the Belgian Bone Club. Osteoporos Int. 2007;18:1439–50.PubMedCrossRef Body JJ, Bergmann P, Boonen S, et al. Management of cancer treatment-induced bone loss in early breast and prostate cancer: a consensus paper of the Belgian Bone Club. Osteoporos Int. 2007;18:1439–50.PubMedCrossRef
23.
go back to reference Hillner BE, Ingle JN, Chlebowski RT, et al. American Society of Clinical Oncology 2003 update on the role of bisphosphonates and bone health issues in women with breast cancer. J Clin Oncol. 2003;21:4042–57.PubMedCrossRef Hillner BE, Ingle JN, Chlebowski RT, et al. American Society of Clinical Oncology 2003 update on the role of bisphosphonates and bone health issues in women with breast cancer. J Clin Oncol. 2003;21:4042–57.PubMedCrossRef
24.
go back to reference Gralow JR, Biermann JS, Farooki A, et al. NCCN Task Force report: bone health in cancer care. J Natl Compr Cancer Netw. 2009;7 Suppl 3:S1–S32. Gralow JR, Biermann JS, Farooki A, et al. NCCN Task Force report: bone health in cancer care. J Natl Compr Cancer Netw. 2009;7 Suppl 3:S1–S32.
25.
go back to reference Tauchmanova L, Ricci P, Serio B, Lombardi G, Colao A, Rotoli B, et al. Short-term zoledronic acid treatment increases bone mineral density and marrow clonogenic fibroblast progenitors after allogeneic stem cell transplantation. J Clin Endocrinol Metab. 2005;90:627–34.PubMedCrossRef Tauchmanova L, Ricci P, Serio B, Lombardi G, Colao A, Rotoli B, et al. Short-term zoledronic acid treatment increases bone mineral density and marrow clonogenic fibroblast progenitors after allogeneic stem cell transplantation. J Clin Endocrinol Metab. 2005;90:627–34.PubMedCrossRef
26.
go back to reference Chae YS, Kim JG, Moon JH, et al. Pilot study on the use of zoledronic acid to prevent bone loss in allo-SCT recipients. Bone Marrow Transplant. 2009;44:35–41.PubMedCrossRef Chae YS, Kim JG, Moon JH, et al. Pilot study on the use of zoledronic acid to prevent bone loss in allo-SCT recipients. Bone Marrow Transplant. 2009;44:35–41.PubMedCrossRef
27.
go back to reference D’Souza AB, Grigg AP, Szer J, Ebeling PR. Zoledronic acid prevents bone loss after allogeneic hemopoietic stem cell transplantation. Intern Med J. 2006;36:600–3.PubMedCrossRef D’Souza AB, Grigg AP, Szer J, Ebeling PR. Zoledronic acid prevents bone loss after allogeneic hemopoietic stem cell transplantation. Intern Med J. 2006;36:600–3.PubMedCrossRef
28.
go back to reference Moyer VA. U.S. Preventive Services Task Force. Vitamin D and calcium supplementation to prevent fractures in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;158:691–6.PubMed Moyer VA. U.S. Preventive Services Task Force. Vitamin D and calcium supplementation to prevent fractures in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;158:691–6.PubMed
29.
go back to reference Sproat L, Bolwell B, Rybicki L, et al. Vitamin D level after allogeneic hematopoietic stem cell transplant. Biol Blood Marrow Transplant. 2011;17:1079–83.PubMedCrossRef Sproat L, Bolwell B, Rybicki L, et al. Vitamin D level after allogeneic hematopoietic stem cell transplant. Biol Blood Marrow Transplant. 2011;17:1079–83.PubMedCrossRef
30.
go back to reference Joseph RW, Alousi A, Konda B, et al. High incidence of vitamin D deficiency in patients undergoing allogeneic stem cell transplantation. Am J Hematol. 2011;86:954–6.PubMedCrossRef Joseph RW, Alousi A, Konda B, et al. High incidence of vitamin D deficiency in patients undergoing allogeneic stem cell transplantation. Am J Hematol. 2011;86:954–6.PubMedCrossRef
31.
go back to reference North American Menopause Society. The 2012 hormone therapy position statement of: The North American Menopause Society. Menopause. 2012;19:257–71. North American Menopause Society. The 2012 hormone therapy position statement of: The North American Menopause Society. Menopause. 2012;19:257–71.
32.
go back to reference •• Hari P, Defore TE, Vesole DH, et al. Intermittent zolendronic acid prevents bone loss in adults after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2013;19:1361–7. Accessed July 5, 2013. Latest randomized trial supporting the use of zolendronic acid in HCT patients. •• Hari P, Defore TE, Vesole DH, et al. Intermittent zolendronic acid prevents bone loss in adults after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2013;19:1361–7. Accessed July 5, 2013. Latest randomized trial supporting the use of zolendronic acid in HCT patients.
33.
go back to reference Ganguly S, Divine CL, Aljitawi OS, Abhyankar S, et al. Prophylactic use of zoledronic acid to prevent early bone loss is safe and feasible in patients with acute myeloid leukemia undergoing allogeneic stem cell transplantation. Clin Transplant. 2012;26:447–53.PubMedCrossRef Ganguly S, Divine CL, Aljitawi OS, Abhyankar S, et al. Prophylactic use of zoledronic acid to prevent early bone loss is safe and feasible in patients with acute myeloid leukemia undergoing allogeneic stem cell transplantation. Clin Transplant. 2012;26:447–53.PubMedCrossRef
34.
go back to reference Hausmann A, Hill W, Stemmler HJ, et al. Bone loss after allogeneic haematopoietic stem cell transplantation: a pilot study on the use of zoledronic acid. Chemother Res Pract. 2012. [Published online ahead of print April 10, 2012]. Accessed July 5, 2013. Hausmann A, Hill W, Stemmler HJ, et al. Bone loss after allogeneic haematopoietic stem cell transplantation: a pilot study on the use of zoledronic acid. Chemother Res Pract. 2012. [Published online ahead of print April 10, 2012]. Accessed July 5, 2013.
35.
go back to reference Chestnut III CH, Silverman S, Andriano K, et al. A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study. PROOF Study Group. Am J Med. 2000;109:267–76.CrossRef Chestnut III CH, Silverman S, Andriano K, et al. A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study. PROOF Study Group. Am J Med. 2000;109:267–76.CrossRef
36.
go back to reference Traynor K. Experts recommend against calcitonin-salmon for postmenopausal osteoporosis. Am J Health Syst Pharm. 2013;70:648–50.PubMedCrossRef Traynor K. Experts recommend against calcitonin-salmon for postmenopausal osteoporosis. Am J Health Syst Pharm. 2013;70:648–50.PubMedCrossRef
37.
go back to reference Andrews EB, Gilsenan AW, Midkiff K, et al. The US post-marketing surveillance study of adult osteosarcoma and teriparatide: study design and findings from the first 7 years. J Bone Miner Res. 2012;27:2429–37.PubMedCrossRef Andrews EB, Gilsenan AW, Midkiff K, et al. The US post-marketing surveillance study of adult osteosarcoma and teriparatide: study design and findings from the first 7 years. J Bone Miner Res. 2012;27:2429–37.PubMedCrossRef
38.
go back to reference Watanabe A, Yoneyama S, Nakajima M, et al. Osteosarcoma in Sprague-Dawley rats after long-term treatment with teriparatide (human parathyroid hormone (1–34)). J Toxicol Sci. 2012;37:617–29.PubMedCrossRef Watanabe A, Yoneyama S, Nakajima M, et al. Osteosarcoma in Sprague-Dawley rats after long-term treatment with teriparatide (human parathyroid hormone (1–34)). J Toxicol Sci. 2012;37:617–29.PubMedCrossRef
39.
go back to reference Finkelstein JS, Wyland JJ, Lee H, et al. Effects of teriparatide, alendronate, or both in women with postmenopausal osteoporosis. J Clin Endocrinol Metab. 2010;95:1838–45.PubMedCrossRef Finkelstein JS, Wyland JJ, Lee H, et al. Effects of teriparatide, alendronate, or both in women with postmenopausal osteoporosis. J Clin Endocrinol Metab. 2010;95:1838–45.PubMedCrossRef
40.
go back to reference Miller PD, Delmas PD, Lindsay R, et al. Early responsiveness of women with osteoporosis to teriparatide after therapy with alendronate or risedronate. J Clin Endocrinol Metab. 2008;93:3785–93.PubMedCrossRef Miller PD, Delmas PD, Lindsay R, et al. Early responsiveness of women with osteoporosis to teriparatide after therapy with alendronate or risedronate. J Clin Endocrinol Metab. 2008;93:3785–93.PubMedCrossRef
41.
go back to reference Black DM, Greenspan SL, Ensrud KE, et al. The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis. N Engl J Med. 2003;349:1207–15.PubMedCrossRef Black DM, Greenspan SL, Ensrud KE, et al. The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis. N Engl J Med. 2003;349:1207–15.PubMedCrossRef
42.
go back to reference Finkelstein JS, Leder BZ, Burnett SM, et al. Effects of teriparatide, alendronate, or both on bone turnover in osteoporotic men. J Clin Endocrinol Metab. 2006;91:2882–7.PubMedCrossRef Finkelstein JS, Leder BZ, Burnett SM, et al. Effects of teriparatide, alendronate, or both on bone turnover in osteoporotic men. J Clin Endocrinol Metab. 2006;91:2882–7.PubMedCrossRef
43.
go back to reference •• Tsai JN, Uihlein AV, Lee H, et al. Teriparatide and denosumab, alone or combined, in women with postmenopausal osteoporosis: the DATA study randomized trial. Lancet. 2013;382:50–6. One of the first publications on the rational use of newer agents to improve BMD in non-HCT patients.PubMedCrossRef •• Tsai JN, Uihlein AV, Lee H, et al. Teriparatide and denosumab, alone or combined, in women with postmenopausal osteoporosis: the DATA study randomized trial. Lancet. 2013;382:50–6. One of the first publications on the rational use of newer agents to improve BMD in non-HCT patients.PubMedCrossRef
44.
go back to reference •• Majhail NS, Rizzo JD, Lee SJ, et al. Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2012;18:348–71. Excellent comprehensive review of guidelines for post-HCT survivorship.PubMedCrossRef •• Majhail NS, Rizzo JD, Lee SJ, et al. Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2012;18:348–71. Excellent comprehensive review of guidelines for post-HCT survivorship.PubMedCrossRef
45.
go back to reference • McClune BL, Polgreen LE, Burmeister LA, et al. Screening, prevention and management of osteoporosis and bone loss in adult and pediatric hematopoietic cell transplant recipients. Bone Marrow Transplant. 2011;46:1–9. Single center review and recommendations for OP/osteopenia screening and treatment in a HCT recipients.PubMedCrossRef • McClune BL, Polgreen LE, Burmeister LA, et al. Screening, prevention and management of osteoporosis and bone loss in adult and pediatric hematopoietic cell transplant recipients. Bone Marrow Transplant. 2011;46:1–9. Single center review and recommendations for OP/osteopenia screening and treatment in a HCT recipients.PubMedCrossRef
Metadata
Title
Osteoporosis after Stem Cell Transplantation
Authors
Brian L. McClune
Navneet S. Majhail
Publication date
01-12-2013
Publisher
Springer US
Published in
Current Osteoporosis Reports / Issue 4/2013
Print ISSN: 1544-1873
Electronic ISSN: 1544-2241
DOI
https://doi.org/10.1007/s11914-013-0180-1

Other articles of this Issue 4/2013

Current Osteoporosis Reports 4/2013 Go to the issue

Epidemiology and Pathophysiology (RA Adler, Section Editor)

Recent Advances: Osteoporosis in the “Oldest Old”

Quality of Care in Osteoporosis (SL Silverman, Section Editor)

Review of New Guidelines for the Management of Glucocorticoid Induced Osteoporosis

Osteoporosis and Cancer (P Taxel, Section Editor)

Skeletal Manifestations of Treatment of Breast Cancer

Quality of Care in Osteoporosis (SL Silverman, Section Editor)

Commentary: Measuring Quality of Care in Osteoporosis

The Why and How of Fracture Liaison Services (SL Silverman, Section Editor)

Fracture Liaison Services in an Open System: How was it Done? What Were the Barriers and How Were They Overcome?

Osteoporosis and Cancer (P Taxel, Section Editor)

Effects of Radiation on Bone