How to manage osteoporosis in hematologic stem cell transplant recipients

INTERNATIONAL OSTEOPOROSIS FOUNDATION

Impaired bone health is among the most significant long-term consequences of hematopoietic stem cell transplantation (HSCT), a common therapy for patients with malignant and non-malignant haematological diseases. 

To address this serious problem, the International Osteoporosis Foundation (IOF) expert Working Group on Cancer and Bone Disease has published a new Executive Summary of its authoritative state-of-the-art review. The review outlined the major factors affecting bone health in HSCT patients, and provided expert guidance for the monitoring, evaluation and treatment of bone loss in these patients. Published in the Journal of Bone Oncology, the Executive Summary now provides a helpful management algorithm and succinct key guidance based on the Working Group’s expert opinion.

Professor René Rizzoli, Chair of the IOF Cancer and Bone Working Group and Emeritus Professor of Medicine at the University Hospitals of Geneva, Switzerland, stated:

“This concise summary aims to encourage and assist haematologists and oncologists in addressing osteoporosis and fracture prevention in their hematopoietic stem cell transplantation patients. The ‘check list’ includes bone mineral density examination, evaluation of clinical risk factors, and general dietary and physical activity measures, with appropriate application of osteoporosis pharmacotherapies in those who are found to be at increased high risk of fracture.”

Professor Nicholas Harvey, Chair of the IOF Committee of Scientific Advisors and Professor of Rheumatology and Clinical Epidemiology at the MRC Lifecourse Epidemiology Unit, University of Southampton, UK added:

“Unfortunately, too many hematopoietic stem cell transplantation recipients are not being monitored and treated for bone fragility, despite the fact that poor bone health is a significant comorbidity post-HSCT. We therefore urge all physicians who care for HSCT recipients to take action to protect their patients’ long-term bone health. It is important to keep in mind that fragility fractures can be severely debilitating, with resulting loss of physical independence and quality of life.”