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Journal of Endocrinological Investigation

, Volume 33, Issue 7, pp 478–482 | Cite as

Quantitative ultrasound detects bone changes following bone marrow transplantation in pediatric subjects with hematological diseases: A longitudinal study

  • N. Di Iorgi
  • E. Calandra
  • A. Secco
  • F. Napoli
  • A. Calcagno
  • M. Ghezzi
  • C. Frassinetti
  • F. De Terlizzi
  • G. Giorgiani
  • F. Locatelli
  • M. Maghnie
Original Articles

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.

Keywords

Bone bone marrow transplantation childhood GVHD quantitative ultrasound 

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Copyright information

© Italian Society of Endocrinology (SIE) 2010

Authors and Affiliations

  • N. Di Iorgi
    • 1
  • E. Calandra
    • 1
  • A. Secco
    • 1
  • F. Napoli
    • 1
  • A. Calcagno
    • 1
  • M. Ghezzi
    • 1
  • C. Frassinetti
    • 1
  • F. De Terlizzi
    • 2
  • G. Giorgiani
    • 3
  • F. Locatelli
    • 3
  • M. Maghnie
    • 1
  1. 1.Department of Pediatrics IRCCS, Giannina GasliniUniversity of GenovaGenovaItaly
  2. 2.IGEA Biophysics laboratory (F.D.T.)Carpi
  3. 3.Pediatric Hematology/Oncology, IRCCS Policlinico S. MatteoUniversity of PaviaPaviaItaly

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