دورية أكاديمية

Non-osteopenic Bone Pathology After Allo-hematopoietic Stem Cell Transplantation in Patients with Inborn Errors of Immunity

التفاصيل البيبلوغرافية
العنوان: Non-osteopenic Bone Pathology After Allo-hematopoietic Stem Cell Transplantation in Patients with Inborn Errors of Immunity
المؤلفون: Golwala, Zainab M, Bhat, Nikita Gireesh, Xu-Bayford, Jinhua, Stankova, Tanja, Adams, Stuart, Morris, Emma C, Qasim, Waseem, Booth, Claire, Worth, Austen, Kusters, Maaike A, Elfeky, Reem
المصدر: Journal of Clinical Immunology (2023)
سنة النشر: 2023
المجموعة: University College London: UCL Discovery
مصطلحات موضوعية: Bone marrow transplantation, Bone pathology, HSCT, Inborn errors of immunity, Long term follow-up, Osteochondroma, Osteopenia, Skeletal dysplasia, WAS
الوصف: PURPOSE: There is a lack of data on post-HSCT non-osteopenic bone pathology specifically for children with inborn errors of immunity (IEI). We collected data on non-osteopenic bone pathology in children with IEI post-HSCT over two decades in a large tertiary pediatric immunology center. METHODS: Descriptive study with data analysis of bone pathology in allo-HSCT for IEI was performed between 1/1/2000 to 31/12/2018 including patients alive at follow-up to July 2022. Records were analyzed for bone pathology and risk factors. Exclusion criteria included isolated reduced bone density, fractures, and skeletal anomalies due to underlying IEI and short stature without other bone pathology. Bone pathologies were divided into 5 categories: bone tumors; skeletal dysplasia; avascular necrosis; evolving bone deformities; slipped upper femoral epiphysis. RESULTS: A total of 429 children received HSCT between 2000 and 2018; 340 are alive at last assessment. Non-osteopenic bone pathology was observed post-HSCT in 9.4% of patients (32/340, mean 7.8 years post-HSCT). Eleven patients (34%) had > 1 category of bone pathology. Seventeen patients (17/32; 53%) presented with bilateral bone pathology. The majority of patients received treosulfan-based conditioning (26/32; 81.2%). Totally, 65.6% (21/32) of patients had a history of prolonged steroid use (> 6 months). Pain was the presenting symptom in 66% of patients, and surgical intervention was required in 43.7%. The highest incidence of bone pathologies was seen in Wiskott-Aldrich syndrome (WAS) (n = 8/34; 23.5%) followed by hemophagocytic lymphohistiocytosis patients (n = 3/16; 18.8%). CONCLUSION: Non-osteopenic bone pathology in long-term survivors of allo-HSCT for IEI is not rare. Most patients did not present with complaints until at least 5 years post-HSCT highlighting the need for ongoing bone health assessment for patients with IEI. Children presenting with stunted growth and bone pathology post-HSCT should undergo skeletal survey to rule out development of post-HSCT ...
نوع الوثيقة: article in journal/newspaper
وصف الملف: text
اللغة: English
العلاقة: https://discovery.ucl.ac.uk/id/eprint/10167119/1/s10875-023-01465-z.pdfTest; https://discovery.ucl.ac.uk/id/eprint/10167119Test/
الإتاحة: https://discovery.ucl.ac.uk/id/eprint/10167119/1/s10875-023-01465-z.pdfTest
https://discovery.ucl.ac.uk/id/eprint/10167119Test/
حقوق: open
رقم الانضمام: edsbas.E6134AC5
قاعدة البيانات: BASE