Decreased bone mineral density is common after autologous blood or marrow transplantation

Survivors of autologous blood or marrow transplantation (ABMT) are predispo sed to decreased bone mineral density (BMD), but data are lacking on the in cidence and risk factors for this condition. Therefore, we measured BMD in 64 of 68 consecutive ABMT survivors (35 men and 29 women) attending the Uni versity of Toronto ABMT long-term follow-up clinic. Patients were evaluated a median of 4.2 years (range: 4.9 months-11.4 years) after ABMT. Median ag e at evaluation was 49.6 years (range: 23.5-68.2 years). At the L4 vertebra e, 17 (26%) patients (eight men and nine women) had osteopenia and one male (2%) had osteoporosis. Mean BMD at L1-L4 did not differ from healthy young adults or age and sex matched controls. At the femoral neck, 30 patients ( 46%) (18 men and 12 women) had osteopenia and five (8%) (two men and three women) had osteoporosis. Mean BMD at the femoral neck was significantly low er than in healthy young adults and age- and sex-matched controls. By regre ssion analysis, patients with decreased BMD were older than those with norm al BMD (P = 0.02). Gender, body mass index, time from BMT to evaluation and presence of hypogonadism were not associated with decreased BMD. Treatment of decreased bone density was instituted and follow-up data were obtained 1 year after treatment in 22 of 39 patients with reduced BMD. Nineteen (86% ) patients had stabilization or improvement of their bone density at follow -up. We conclude that, after ABMT, over half of the patients have evidence of osteopenia or osteoporosis. Men and women were equally affected. In our study, only older age at evaluation was predictive for loss of BMD. We reco mmend the measurement of BMD as an integral component to the follow-up of A BMT patients.