Các dấu hiệu chuyển hóa xương như một công cụ hỗ trợ theo dõi loãng xương sau khi ghép tế bào gốc tạo máu đồng loại

Annals of Hematology - Tập 99 - Trang 1873-1882 - 2020
Shuhei Kurosawa1, Noriko Doki1, Yasushi Senoo2, Yuya Kishida1, Akihito Nagata1, Yuta Yamada1, Tatsuya Konishi1, Satoshi Kaito1, Kota Yoshifuji1, Naoki Matsuyama1, Shuichi Shirane1, Tomoyuki Uchida1, Kyoko Inamoto1, Takashi Toya1, Aiko Igarashi1, Yuho Najima1, Hideharu Muto1, Takeshi Kobayashi1, Kazuhiko Kakihana1, Hisashi Sakamaki1, Kazuteru Ohashi1
1Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-ku, Japan
2Department of Internal Medicine, Division of Hematology, Shinshu University School of Medicine, Matsumoto city, Japan

Tóm tắt

Các dấu hiệu chuyển hóa xương (BTMs) là những thông số hữu ích để đánh giá nguy cơ gãy xương và khác với mật độ khoáng xương (BMD), có thể được đo tại bất kỳ cơ sở nào. Tuy nhiên, các giá trị BTM chưa được thiết lập ở những bệnh nhân sau khi ghép tế bào gốc tạo máu đồng loại (allo-HSCT). Chúng tôi đã nghiên cứu tính khả thi của BTMs ở những bệnh nhân đã trải qua allo-HSCT bằng cách đo nồng độ dấu hiệu hấp thu xương trong huyết thanh, phosphatase axit kháng tartrate-5b (TRACP-5b), và dấu hiệu hình thành xương, phosphatase kiềm đặc hiệu xương (BAP), cùng với BMD, 1 tháng trước và 6 tháng sau khi thực hiện allo-HSCT. Bệnh nhân được phân loại thành nhóm alendronate (n = 14) nếu được điều trị alendronate (35 mg đường uống mỗi tuần) trước allo-HSCT hoặc trong vòng 1 tháng sau khi ghép, hoặc nhóm kiểm soát (n = 16), trong đó các bệnh nhân không được điều trị alendronate. Mặc dù tần suất người dùng corticosteroid trong nhóm alendronate cao (71.4% so với 18.9%; p < 0.01), tỷ lệ thay đổi trung bình trong BMD tại cột sống thắt lưng (−2.9% so với −3.1%; p = 0.44) và cổ xương đùi (−3.2% so với −4.1%; p = 1.00), nồng độ TRACP-5b (−4.8% so với 9.9%; p = 0.45), và nồng độ BAP (6.9% so với 1.0%; p = 0.85) trong 6 tháng không khác biệt đáng kể giữa nhóm alendronate và nhóm kiểm soát. Ngoài ra, tỷ lệ thay đổi trong BMD tại cột sống thắt lưng có mối liên hệ tiêu cực với nồng độ TRACP-5b 6 tháng sau allo-HSCT (p = 0.03, r = 0.40). Kết quả của chúng tôi cho thấy hiệu quả có thể của việc điều trị alendronate ở bệnh nhân allo-HSCT. Mức độ BTM có thể hữu ích để theo dõi sự thay đổi BMD.

Từ khóa

#bone turnover markers #BTM #osteoporosis #allogeneic hematopoietic stem cell transplantation #allo-HSCT #alendronate #phosphatase alkaline #TRACP-5b #BAP

Tài liệu tham khảo

Baker KS, Ness KK, Weisdorf D, Francisco L, Sun CL, Forman S, Bhatia S (2010) Late effects in survivors of acute leukemia treated with hematopoietic cell transplantation: a report from the bone marrow transplant survivor study. Leukemia 24(12):2039–2047 Anandi P, Jain NA, Tian X, Wu CO, Pophali PA, Koklanaris E, Ito S, Savani BN, Barrett J, Battiwalla M (2016) Factors influencing the late phase of recovery after bone mineral density loss in allogeneic stem cell transplantation survivors. Bone Marrow Transplant 51(8):1101–1106 Pundole X, Cheema HI, Petitto GS, Lopez-Olivo MA, Suarez-Almazor ME, Lu H (2017) Prevention and treatment of bone loss and fractures in patients undergoing a hematopoietic stem cell transplant: a systematic review and meta-analysis. Bone Marrow Transplant 52(5):663–670 Pundole XN, Barbo AG, Lin H, Champlin RE, Lu H (2015) Increased incidence of fractures in recipients of hematopoietic stem-cell transplantation. J Clin Oncol 33(12):1364–1370 Yao S, McCarthy PL, Dunford LM, Roy DM, Brown K, Paplham P et al (2008) High prevalence of early-onset osteopenia/osteoporosis after allogeneic stem cell transplantation and improvement after bisphosphonate therapy. Bone Marrow Transplant 41(4):393–398 Clowes JA, Hannon RA, Yap TS, Hoyle NR, Blumsohn A, Eastell R (2002) Effect of feeding on bone turnover markers and its impact on biological variability of measurements. Bone 30(6):886–890 Melton LJ 3rd, Khosla S, Atkinson EJ, O’Fallon WM, Riggs BL (1997) Relationship of bone turnover to bone density and fractures. J Bone Miner Res 12(7):1083–1091 Bauer DC, Garnero P, Hochberg MC, Santora A, Delmas P, Ewing SK, Black DM, Fracture Intervention Research Group (2006) Fracture intervention research group. Pretreatment levels of bone turnover and the antifracture efficacy of alendronate: the fracture intervention trial. J Bone Miner Res 21(2):292–299 Suzuki Y, Nawata H, Soen S, Fujiwara S, Nakayama H, Tanaka I, Ozono K, Sagawa A, Takayanagi R, Tanaka H, Miki T, Masunari N, Tanaka Y (2014) Guidelines on the management and treatment of glucocorticoid-induced osteoporosis of the Japanese Society for Bone and Mineral Research: 2014 update. J Bone Miner Metab 32(4):337–350 Mori J, Ohashi K, Yamaguchi T, Ando M, Hirashima Y, Kobayashi T, Kakihana K, Sakamaki H (2012) Risk assessment for acute kidney injury after allogeneic hematopoietic stem cell transplantation based on acute kidney injury network criteria. Intern Med 51(16):2105–2110 Ikegame K, Yoshida T, Yoshihara S, Daimon T, Shimizu H, Maeda Y, Ueda Y, Kaida K, Ishii S, Taniguchi K, Okada M, Tamaki H, Okumura H, Kaya H, Kurokawa T, Kodera Y, Taniguchi S, Kanda Y, Ogawa H (2015) Unmanipulated Haploidentical reduced-intensity stem cell transplantation using fludarabine, busulfan, low-dose antithymocyte globulin, and steroids for patients in non-complete remission or at high risk of relapse: a prospective multicenter phase I/II study in Japan. Biol Blood Marrow Transplant 21(8):1495–1505 Coco M, Pullman J, Cohen HW, Lee S, Shapiro C, Solorzano C, Greenstein S, Glicklich D (2012) Effect of risedronate on bone in renal transplant recipients. J Am Soc Nephrol 23(8):1426–1437 Orimo H, Hayashi Y, Fukunaga M, Sone T, Fujiwara S, Shiraki M, Kushida K, Miyamoto S, Soen S, Nishimura J, Oh-Hashi Y, Hosoi T, Gorai I, Tanaka H, Igai T, Kishimoto H, Osteoporosis Diagnostic Criteria Review Committee: Japanese Society for Bone and Mineral Research (2001) Diagnostic criteria for primary osteoporosis: year 2000 revision. J Bone Miner Metab 19(6):331–337 Nishizawa Y, Inaba M, Ishii M, Yamashita H, Miki T, Goto H, Yamada S, Chaki O, Kurasawa K, Mochizuki Y (2008) Reference intervals of serum tartrate-resistant acid phosphatase type 5b activity measured with a novel assay in Japanese subjects. J Bone Miner Metab 26(3):265–270 Kress BC, Mizrahi IA, Armour KW, Marcus R, Emkey RD, Santora AC 2nd (1999) Use of bone alkaline phosphatase to monitor alendronate therapy in individual postmenopausal osteoporotic women. Clin Chem 45(7):1009–1017 Kanda Y (2013) Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 48(3):452–458 Iki M, Akiba T, Matsumoto T, Nishino H, Kagamimori S, Kagawa Y, Yoneshima H, JPOS Study Group Reference database of biochemical markers of bone turnover for the Japanese female population (2004) Japanese population-based osteoporosis (JPOS) study. Osteoporos Int 15(12):981–991 Tauchmanova L, Ricci P, Serio B, Lombardi G, Colao A, Rotoli B et al (2005) Short-term zoledronic acid treatment increases bone mineral density and marrow clonogenic fibroblast progenitors after allogeneic stem cell transplantation. J Clin Endocrinol Metab 90(2):627–634 Delmas PD, Eastell R, Garnero P, Seibel MJ, Stepan J (2000) The use of biochemical markers of bone turnover in osteoporosis. Committee of Scientific Advisors of the International Osteoporosis Foundation. Osteoporos Int 11 Suppl 6:S2–17 Nishizawa Y, Ohta H, Miura M, Inaba M, Ichimura S, Shiraki M, Takada J, Chaki O, Hagino H, Fujiwara S, Fukunaga M, Miki T, Yoshimura N (2013) Guidelines for the use of bone metabolic markers in the diagnosis and treatment of osteoporosis (2012 edition). J Bone Miner Metab 31(1):1–15 Yamada S, Inaba M, Kurajoh M, Shidara K, Imanishi Y, Ishimura E, Nishizawa Y (2008) Utility of serum tartrate-resistant acid phosphatase (TRACP5b) as a bone resorption marker in patients with chronic kidney disease: independence from renal dysfunction. Clin Endocrinol 69(2):189–196 Mitsuboshi S, Yamada H, Nagai K, Okajima H (2018) Clinical advantage and tolerability of ibandronate in hemodialysis patients: a retrospective study. Renal Replacement Therapy 4. https://doi.org/10.1186/s41100-018-0144-0 Stern JM, Sullivan KM, Ott SM, Seidel K, Fink JC, Longton G, Sherrard DJ (2001) Bone density loss after allogeneic hematopoietic stem cell transplantation: a prospective study. Biol Blood Marrow Transplant 7(5):257–264 Kendler DL, Body JJ, Brandi ML et al (2018) Bone management in hematologic stem cell transplant recipients. Osteoporos Int 29(12):2597–2610 Tauchmanova L, Colao A, Lombardi G, Rotoli B, Selleri C (2007) Bone loss and its management in long-term survivors from allogeneic stem cell transplantation. J Clin Endocrinol Metab 92(12):4536–4545 Tauchmanova L, Selleri C, Esposito M, Di Somma C, Orio F Jr, Bifulco G et al (2003) Beneficial treatment with risedronate in long-term survivors after allogeneic stem cell transplantation for hematological malignancies. Osteoporos Int 14(12):1013–1019 Tauchmanova L, De Simone G, Musella T, Orio F, Ricci P, Nappi C et al (2006) Effects of various antireabsorptive treatments on bone mineral density in hypogonadal young women after allogeneic stem cell transplantation. Bone Marrow Transplant 37(1):81–88 Kananen K, Volin L, Laitinen K, Alfthan H, Ruutu T, Valimaki MJ (2005) Prevention of bone loss after allogeneic stem cell transplantation by calcium, vitamin D, and sex hormone replacement with or without pamidronate. J Clin Endocrinol Metab 90(7):3877–3885 Grigg AP, Shuttleworth P, Reynolds J, Schwarer AP, Szer J, Bradstock K, Hui C, Herrmann R, Ebeling PR (2006) Pamidronate reduces bone loss after allogeneic stem cell transplantation. J Clin Endocrinol Metab 91(10):3835–3843 Hari P, DeFor TE, Vesole DH, Bredeson CN, Burns LJ (2013) Intermittent zoledronic acid prevents bone loss in adults after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant 19(9):1361–1367 Chae YS, Kim JG, Moon JH, Kim SN, Lee SJ, Kim YJ, Sohn SK (2009) Pilot study on the use of zoledronic acid to prevent bone loss in allo-SCT recipients. Bone Marrow Transplant 44(1):35–41