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Bone loss and vitamin D deficiency in children undergoing hematopoietic cell transplantation
Author(s) -
Bechard Lori J.,
Gordon Catherine,
Feldman Henry A.,
Venick Robert,
Gura Kathleen,
Guinan Eva C.,
Duggan Christopher
Publication year - 2015
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25370
Subject(s) - medicine , bone mineral , vitamin d and neurology , vitamin d deficiency , transplantation , bone health , prospective cohort study , vitamin , bone density , lean body mass , hematopoietic stem cell transplantation , endocrinology , cohort , gastroenterology , physiology , osteoporosis , body weight
Background Hematopoietic cell transplantation (HCT) may be detrimental to bone health and vitamin D status in children. Procedure We conducted a prospective, multicenter cohort study to identify changes in bone health markers during the first 100 days after allogeneic HCT in 26 children. Bone mineral density (BMD), bone mineral content (BMC), and serum 25‐hydroxyvitamin D (25OHD) concentrations were measured at baseline, 30 days, and 100 days after HCT. Results Mean (SD) BMD and BMC Z‐scores (−0.48 ± 1.09 and −0.98 ± 1.26, respectively) were normal at baseline. Repeated‐measures analysis revealed significant declines in BMD and BMC Z‐scores over the 100 day study period, when adjusted for age, sex, Tanner stage, lean mass, fat mass, resting energy expenditure, total energy intake, insulin sensitivity, serum phosphorus, and inpatient steroid intake. Adjusted mean (SE) 25OHD concentrations declined from 29.2 (3.1) ng/ml at baseline, to 17.7 (1.8) ng/ml at 100 days after HCT. Vitamin D deficiency (25OHD <20 ng/ml) was present in 50% of patients 100 days after HCT. Conclusions Significant bone loss and vitamin D deficiency occur in children in the first 100 days following allogeneic HCT. Strategies to diminish acute bone loss during HCT in children are needed. Pediatr Blood Cancer 2015;62:687–692. © 2015 Wiley Periodicals, Inc.