title: Quantitative ultrasound detects bone changes following bone marrow transplantation in pediatric subjects with hematological diseases: a longitudinal study.
abstract: BACKGROUND
  Bone marrow transplantation (BMT) is associated with bone morbidity. We investigated bone status with quantitative ultrasound (QUS) in pediatric patients with hematological diseases prior to and up to 3 yr following BMT.
  
  
  METHODS
  Phalangeal QUS measures for amplitude- dependent speed of sound (Ad-SoS) and bone transmission time (BTT) were obtained in 40 hematological patients (25 with malignant, 15 with non-malignant disease; 9.7+/-4.9 yr) before BMT and 6, 12, 24, and 36 months after BMT. Bone parameters were expressed as Z-scores based on age-sex-matched normal controls.
  
  
  RESULTS
  Mean Ad-SoS and BTT Z-scores were normal before BMT and reduced at 36 months (analysis of variance: p=0.0542 and p=0.0233). Ad-SoS and BTT Z-scores remained relatively stable in the first 6 months after BMT and then progressively decreased reaching a plateau at 12-36 months. In non-malignant patients, BTT Z-score decreased at 6-12 months (p=0.029) and subsequently increased, while in malignant patients BTT Z-score showed a decrease at 12-24 months. Pre-pubertal subjects displayed a drop of BTT Z-Score values at both 12 (p=0.023) and 36 months after BMT (p=0.049), while BTT Z-score remained relatively unchanged in pubertal subjects. Early impairment of BTT Z-score was found in patients who suffered acute graft versus host disease (GVHD) compared to patients without this clinical condition; BTT Z-score was lower at 36 months (p=0.045).
  
  
  CONCLUSIONS
  Longitudinal assessment by QUS of pediatric BMT survivors evidenced that bone status is mildly affected up to 36 months after BMT, mainly in malignant patients, in pre-pubertal subjects at BMT and in patients who suffered acute GVHD.
authors.affiliation: Department of Pediatrics, IRCCS G. Gaslini, University of Genoa, Largo G. Gaslini 5, 16147 Genoa, Italy. natasciadiiorgi@ospedale-gaslini.ge.it
authors.forename: N
authors.initials: N
authors.lastname: Di Iorgi
authors.forename: E
authors.initials: E
authors.lastname: Calandra
authors.forename: A
authors.initials: A
authors.lastname: Secco
authors.forename: F
authors.initials: F
authors.lastname: Napoli
authors.forename: A
authors.initials: A
authors.lastname: Calcagno
authors.forename: M
authors.initials: M
authors.lastname: Ghezzi
authors.forename: C
authors.initials: C
authors.lastname: Frassinetti
authors.forename: F
authors.initials: F
authors.lastname: De Terlizzi
authors.forename: G
authors.initials: G
authors.lastname: Giorgiani
authors.forename: F
authors.initials: F
authors.lastname: Locatelli
authors.forename: M
authors.initials: M
authors.lastname: Maghnie
mesh_terms: D000293:Adolescent; D015519:Bone Density; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000000981:diagnostic imaging; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D050278:Finger Phalanges / Q000000981:diagnostic imaging; D006086:Graft vs Host Disease / Q000473:pathology; D006402:Hematologic Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011627:Puberty; D014463:Ultrasonography; D055815:Young Adult