Quantitative ultrasound detects bone impairment after bone marrow transplantation in children and adolescents affected by hematological diseases.
OBJECTIVE
Bone marrow transplantation (BMT) recipients are at risk of bone mass impairment and skeletal morbidity. We investigated bone status with quantitative ultrasound (QUS) technique in children and adolescents with hematological diseases before and after BMT.


METHODS
Phalangeal QUS measures for amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT) were obtained in 144 hematological patients (81M, 63F; 11.6+/-5.2 years); forty two were evaluated before BMT and 102 after allogeneic or autologous BMT. Bone parameters were expressed as Z-scores based on age-sex-matched normal controls.


RESULTS
Mean BTT Z-score was reduced in subjects after BMT compared to patients before BMT (M, -0.35+/-1.04 vs. 0.70+/-1.11, P<0.001; F, -0.60+/-1.23 vs. 0.23+/-1.17, P<0.05). Females and males with hormone deficiencies showed reduced BTT Z-scores when compared with subjects without hormone defects (M, -0.52+/-1.0 vs. 0.05+/-1.17, P<0.05; F, -0.50+/-1.27 vs. -0.19+/-1.26; P=0.06). AD-SoS and BTT Z-scores were reduced in 15 subjects with fractures and/or avascular osteonecrosis compared to patients without bone events (-1.52+/-1.7 vs. -0.41+/-1.32 and -0.85+/-1.19 vs. -0.10+/-1.18; both Ps<0.05). Bone event cumulative incidence was 4 times greater in subjects who suffered from chronic GVHD.


CONCLUSIONS
Assessment of phalangeal QUS in young BMT survivors points towards impairment of bone status and endocrine dysfunction and chronic GVHD as risk factors of adverse bone events.
Di Iorgi
Natascia
N
Department of Pediatrics, IRCCS G. Gaslini, University of Genova, Largo Gerolamo Gaslini, 5, 16147, Genova, Italy.
Muratori
Tiziana
T
Department of Pediatric Hematology/Oncology, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy.
Secco
Andrea
A
Department of Pediatrics, IRCCS G. Gaslini, University of Genova, Largo Gerolamo Gaslini, 5, 16147, Genova, Italy.
Napoli
Flavia
F
Department of Pediatrics, IRCCS G. Gaslini, University of Genova, Largo Gerolamo Gaslini, 5, 16147, Genova, Italy.
Fratangeli
Nadia
N
Department of Pediatrics, IRCCS G. Gaslini, University of Genova, Largo Gerolamo Gaslini, 5, 16147, Genova, Italy.
De Terlizzi
Francesca
F
IGEA Biophysics Laboratory, Carpi, Italy.
Giorgiani
Giovanna
G
Department of Pediatric Hematology/Oncology, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy.
Locatelli
Franco
F
Department of Pediatric Hematology/Oncology, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy.
Maghnie
Mohamad
M
Department of Pediatrics, IRCCS G. Gaslini, University of Genova, Largo Gerolamo Gaslini, 5, 16147, Genova, Italy. Electronic address: mohamadmaghnie@ospedale-gaslini.ge.it.
D000293:Adolescent; D001847:Bone Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000209:etiology; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D019337:Hematologic Neoplasms / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D014463:Ultrasonography