Bone mineral density of patients with thalassemia major: Four-year follow-up

The purpose of this study was to evaluate the bone mineral density (BMD) of 50 patients aged 9-28 years, with thalassemia major and to assess the alte rations of bone density in a 4-year follow-up study. They were measured wit h a DPX densitometer at the lumbar spine and femur area and divided into th ree groups: preadolescents, adolescents, and adults. All patients received calcium and vitamin D supplements, and 8 of the 50 received hormone replace ment therapy (HRT). All patients had a significantly lower BMD compared wit h healthy subjects. Mean values of lumbar BMD of the three groups were 1.3, 2, and 3 standard deviations (SDs) lower than those of healthy subjects of the same age. All adolescent patients with normal gonadal function and tho se who received HRT showed an increase in BMD during the period of the stud y. Adult:patients also showed an increase in bone density as long as the tr eatment lasted. However, adolescent and adult patients who had hypogonadotr opic hypogonadism but could not get therapy showed a decrease in bone densi ty. BMD of patients with thalassemia major shows a good index of bone statu s which should be evaluated, especially for the determination and follow-up of therapy.