» Articles » PMID: 28628088

An Individualised Risk-adapted Protocol of Pre- and Post Transplant Zoledronic Acid Reduces Bone Loss After Allogeneic Stem Cell Transplantation: Results of a Phase II Prospective Trial

Overview
Specialty General Surgery
Date 2017 Jun 20
PMID 28628088
Citations 5
Authors
Affiliations
Soon will be listed here.
Abstract

Bone loss occurs frequently following allogeneic haematopoietic stem cell transplantation (alloSCT). The Australasian Leukaemia and Lymphoma Group conducted a prospective phase II study of pretransplant zoledronic acid (ZA) and individualised post-transplant ZA to prevent bone loss in alloSCT recipients. Patients received ZA 4 mg before conditioning. Administration of post-transplant ZA from days 100 to 365 post alloSCT was determined by a risk-adapted algorithm based on serial bone density assessments and glucocorticoid exposure. Of 82 patients enrolled, 70 were alive and without relapse at day 100. A single pretransplant dose of ZA prevented femoral neck bone loss at day 100 compared with baseline (mean change -2.6±4.6%). Using the risk-adapted protocol, 42 patients received ZA between days 100 and 365 post alloSCT, and this minimised bone loss at day 365 compared with pretransplant levels (mean change -2.9±5.3%). Femoral neck bone loss was significantly reduced in ZA-treated patients compared with historical untreated controls at days 100 and 365. This study demonstrates that a single dose of ZA pre-alloSCT prevents femoral neck bone loss at day 100 post alloSCT, and that a risk-adapted algorithm is able to guide ZA administration from days 100 to 365 post transplant and minimise further bone loss.

Citing Articles

Randomized controlled trial of pre-transplant zoledronate versus observation for prevention of bone loss in allogeneic hematopoietic cell transplantation.

Khaire N, Bhattacharjee U, Dinesan A, Sinha A, Bhadada S, Pardeep A Blood Cell Ther. 2024; 7(3):87-94.

PMID: 39263623 PMC: 11384127. DOI: 10.31547/bct-2024-003.


A mechanistic review of chinese medicine polyphenols on bone formation and resorption.

Li Y, Li L, Li X, Luo B, Ye Q, Wang H Front Pharmacol. 2022; 13:1017538.

PMID: 36313339 PMC: 9597080. DOI: 10.3389/fphar.2022.1017538.


Risk Factors and Management of Osteoporosis Post-Transplant.

Kovvuru K, Kanduri S, Vaitla P, Marathi R, Gosi S, Garcia Anton D Medicina (Kaunas). 2020; 56(6).

PMID: 32575603 PMC: 7353876. DOI: 10.3390/medicina56060302.


Immune Modulation Properties of Zoledronic Acid on TcRγδ T-Lymphocytes After TcRαβ/CD19-Depleted Haploidentical Stem Cell Transplantation: An analysis on 46 Pediatric Patients Affected by Acute Leukemia.

Merli P, Algeri M, Galaverna F, Milano G, Bertaina V, Biagini S Front Immunol. 2020; 11:699.

PMID: 32477328 PMC: 7235359. DOI: 10.3389/fimmu.2020.00699.


Bone management in hematologic stem cell transplant recipients.

Kendler D, Body J, Brandi M, Broady R, Cannata-Andia J, Cannata-Ortiz M Osteoporos Int. 2018; 29(12):2597-2610.

PMID: 30178158 DOI: 10.1007/s00198-018-4669-4.

References
1.
Black D, Delmas P, Eastell R, Reid I, Boonen S, Cauley J . Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007; 356(18):1809-22. DOI: 10.1056/NEJMoa067312. View

2.
Pundole X, Barbo A, Lin H, Champlin R, Lu H . Increased incidence of fractures in recipients of hematopoietic stem-cell transplantation. J Clin Oncol. 2015; 33(12):1364-70. PMC: 5320933. DOI: 10.1200/JCO.2014.57.8195. View

3.
Shulman H, Sullivan K, Weiden P, McDonald G, Striker G, Sale G . Chronic graft-versus-host syndrome in man. A long-term clinicopathologic study of 20 Seattle patients. Am J Med. 1980; 69(2):204-17. DOI: 10.1016/0002-9343(80)90380-0. View

4.
Kanis J, Johnell O, Oden A, Johansson H, McCloskey E . FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int. 2008; 19(4):385-97. PMC: 2267485. DOI: 10.1007/s00198-007-0543-5. View

5.
Petropoulou A, Porcher R, Herr A, Devergie A, Brentano T, Ribaud P . Prospective assessment of bone turnover and clinical bone diseases after allogeneic hematopoietic stem-cell transplantation. Transplantation. 2010; 89(11):1354-61. DOI: 10.1097/TP.0b013e3181d84c8e. View