scholarly journals Bone Health Assessment in Patients Undergoing Hematopoietic Cell Transplantation

2015 ◽  
Vol 21 (2) ◽  
pp. S178-S179
Author(s):  
Daniel Ernst ◽  
Pablo Florenzano ◽  
Claudia Campusano ◽  
Veronica Jara ◽  
Pablo Bertin ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
Bone Health ◽  
Hematopoietic Cell Transplantation ◽  
Health Assessment ◽  
Hematopoietic Cell

Bone Health Assesment in Patients Undergoing Hematopoietic Cell Transplantation

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5886-5886
Author(s):  
Pablo Ramirez ◽  
Pablo Florenzano ◽  
Claudia Campusano ◽  
Veronica Jara ◽  
Pablo A Bertin ◽  
...  
Keyword(s):  
Vitamin D ◽  
Secondary Hyperparathyroidism ◽  
Cell Transplantation ◽  
Bone Health ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Main Diagnosis ◽  
Z Score ◽  
Vitamin D Levels ◽  
25 Oh Vitamin D

Abstract INTRODUCTION: The increased survival of hematological patients has required to widen the care of these patients, with emphasis in factors related to quality of life and late mortality. Among them, osteoporosis (OP) is a fundamental problem. Patients undergoing hematopoietic cell transplantation (HCT) are at great risk of OP, mainly due to prolonged exposure to chemotherapy, immunosuppresants and the hypogonadism frequently associated to these treatments. Despite this, there is lack of strong evidence on this matter and HCT guidelines are not clear on this problem. OBJECTIVES: To evaluate parameters related to bone health in patients undergoing HCT. To measure the frequency and severity of the alterations in this group of patients. PATIENTS AND METHODS: Observational and retrospective analysis of patients undergoing HCT at the Catholic University Hematology-Oncology Department. All patients undergoing HCT were recommended to have determination of 25-OH vitamin D, PTHi, Calcium, Phosphorus and bone densitometry (DXA). We included all patients with the evaluation before HCT (preHCT) and 1 year after HCT (postHCT). RESULTS: We obtained data from 20 patients preHCT and 22 patients postHCT. Main diagnosis were acute myeloid leukemia (n=13; 32%), multiple myeloma (n=11; 26%), acute lymphoblastic leukemia (n=9; 21%) and Hodgkin's Lymphoma (n=5; 12%). Mean age was 40 years (range: 17-67) and 67% were males. In the preHCT group, the median 25-OH vitamin D levels were 13,6 ng/ml (range: 4,9-26,7 ng/ml) and 100% of the patients were in the insuficiency range leveles (<30 ng/ml). Median PTHi levels were 62,6 pg/ml (range: 24,4-223,7 pg/ml), and 46% of the patients had secondary hyperparathyroidism. In the postHCT group, median 25-OH vitamina D levels were 11,4 ng/ml (range: 4-29,4 ng/ml) and 100% had insuficiency levels. Median PTHi levels were 68 pg/ml (range: 37,4-135,8 pg/ml), and 56% of the patients had secondary hyperparathyroidism. 12 patients had DXA before HCT and 3 (25%) of them had DXA lumbar Z score less than -2.0. In 19 patients postHCT, 4 (21%) had decreased DXA Z score < 2.0. No difference could be established between autologus or allogeneic HCT in any meassurement. CONCLUSIONS: HCT patients represent a high risk group of developing severe vitamin D deficiency, secondary hyperparathyrodism and decreased DXA levels. These data are a warning that this population of patients requiere early intervention to prevent long term complications. This report is the initial evaluation for the development and treatment of bone health in a prospective matter in HCT patients in our center. Disclosures No relevant conflicts of interest to declare.

Efficacy of keratinocyte growth factor in prevention of oral mucositis in children undergoing allogeneic hematopoietic cell transplantation

2020 ◽  
Vol 51 (3) ◽  
pp. 172-178
Author(s):  
Natalia Bartoszewicz ◽  
Krzysztof Czyżewski ◽  
Robert Dębski ◽  
Anna Krenska ◽  
Ewa Demidowicz ◽  
...  
Keyword(s):  
Growth Factor ◽  
Cell Transplantation ◽  
Oral Mucositis ◽  
Hematopoietic Cell Transplantation ◽  
Clinical Course ◽  
Keratinocyte Growth Factor ◽  
Supportive Therapy ◽  
Primary Objective ◽  
Hematopoietic Cell ◽  
Unrelated Donor

AbstractIntroductionOral mucositis is regarded by patients as one of the worst and debilitating complications of conditioning and hematopoietic cell transplantation (HCT). Prevention of mucositis is one of the priorities of supportive therapy during and after conditioning.ObjectivesThe primary objective of the study was the analysis of efficacy of keratinocyte growth factor (KGF, palifermin) used in prophylaxis of oral mucositis in patients undergoing allo-HCT. The secondary objectives of the study included the analysis of the influence of palifermin on clinical course of oral mucositis and early transplant outcomes, as well as analysis of the contraindications of palifermin in patients undergoing allo-HCT.Patients and methodsA total number of 253 allo-HCT performed between 2003 and 2018 in patients aged 0–19 years in a single center were analyzed. Overall, in 161 HCTs, palifermin was administered.ResultsPatients receiving KGF were transplanted earlier in the context of calendar year, and more often received ATG, mainly due to the higher rate of unrelated donor transplants. Allo-HCT patients who were administered palifermin had shorter time of mucositis (median: 9 vs. 13 days, p < 0.001), lower mucositis grade (median: 2° vs. 3°; p < 0.001), shorter period of total parenteral nutrition (median: 19 vs. 22 days; p = 0.018), and lower incidence of episodes of febrile neutropenia (median: 39.1% vs. 83.1%; p < 0.001).ConclusionsThe use of palifermin has decreased duration and severity of oral mucositis in children after allo-HCT. Palifermin is a safe and well-tolerated compound in children undergoing allo-HCT.

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