REDUCTION OF BONE MASS IN WOMEN AFTER BONE-MARROW TRANSPLANTATION

Osteoporosis is a common disease among patients undergoing transplanta tion. Its prevalence and complications have been well described in sol id organ recipients, especially kidney, liver, and heart. However, stu dies in bone marrow transplantation (BMT) are scarce. hmong the mechan isms invoked in the pathogenesis of BMT osteoporosis are the baseline disease, the use of immunosuppressive drugs and, more remarkably, seco ndary hypogonadism. We present a study of 27 women who underwent BMT, all of them suffering ovarian failure. We studied different biochemica l markers of bone formation/resorption and also evaluated the presence of osteopenia/osteoporosis by dual energy X-ray absorptiometry (DXA) of the lumbar spine. Osteopenia was observed in nine patients (33%) an d osteoporosis in another five (18%), according to the World Health Or ganization criteria. We also detected a subgroup showing elevation of several bone turnover biochemical markers, indicating high osseous rem odeling. A remarkable increase in urine hydroxyproline/creatinine was detected in 95% of cases, although an explanation is lacking. We outli ne a reasonable therapeutic approach for osteoporosis in BMT emphasizi ng the need to monitor these patients after transplantation.