Bone Loss after Allogeneic Haematopoietic Stem Cell Transplantation : A Pilot Study on the Use of Zoledronic Acid

Abstract EN

Purpose.

Bone loss is a common phenomenon following allogeneic haematopoietic stem cell transplantation (allo-HSCT).

The study aimed on tolerance and efficacy of zoledronic acid (ZA) in patients after allo-HSCT.

Methods.

40 patients’ with osteoporosis or osteopenia were recruited on this phase II study.

ZA was given at a dose of 4 mg IV every 3 months for 2 years (yrs).

BMD was determined by dual-energy X-ray absorptiometry (LS lumbar spine, FH femur hip).

Patients were evaluated for deoxypyridinoline (Dpd) and calcium excretion by longitudinal measurements.

Results.

36 patients who had received at least 3 doses of ZA were evaluable.

26 patients had at least two BMD measurements since baseline (BMD group).

Among these patients, BMD increased from 0.97±0.15 to 1.10±0.18 g/cm² (LS baseline—2 yrs, Δ+11.6±6.0%, P<0.001) and from 0.82±0.10 to 0.91±0.10 g/cm² (FH baseline—2 yrs, Δ+7.5±7.0%, P<0.001).

Factors associated with an increase in BMD were younger age, female donor sex, and immunosuppression with CSA/MTX.

Conclusion.

ZA was generally well tolerated; it increases BMD and reduces Dpd excretion significantly in patients with bone loss after allo-HSCT.