Bone Complications in Allogenic Hematopoietic Stem Cell Transplantation

Abstract

Allogenic hematopoietic stem cell transplantation (allogenic HSCT) is employed to treat benign and malignanthematologic disorders. Increased use of allogenic HSCT has improved outcomes and patient survival, but has led to increased complications. Bone complications following HSCT include osteopenia, osteoporosis, avascular necrosis (AVN) and fracture. These complications decrease patient quality of life and increase morbidity. Allogenic HSCTassociated bone loss is linked to multiple factors including pre-transplant physiologic risk, myeloablative regimens, total-body irradiation, graft-versus-host disease (GVHD), immunosuppressive regimens, secondary hypogonadism, intestinal malabsorption and renal dysfunction. However, the precise molecular causes of HSCT-associated bone loss remain to be determined. Herein, we summarize the epidemiology, risk factors, and pathophysiology of allogenic HSCT-related bone loss and fracture. Also, review is made of the current modalities for prevention and treatment of these complications.