Abstract：
In this retrospective cohort study of adult stem cell transplanted patients (n = 8463), a significant increased risk of both MOF and hip fractures was seen compared with the Swedish population and occurred in mean more than 2 years after stem cell transplantation.
OBJECTIVE: To explore the risk for osteoporotic fracture in patients who have undergone hematopoietic stem cell transplantation (HSCT) compared with the Swedish population.
METHODS: The risk of osteoporotic fractures was determined in a retrospective population cohort study of adult (≥ 18 years) Swedish patients (n = 8463), who were transplanted with HSCT 1997-2016 and compared with all adults living in Sweden during the same period.
RESULTS: In the total study group (n = 8463), 90 hip fractures (1.1% both in males and females) and 361 major osteoporotic fractures (MOF) (3.2% in men and 6.0% in women) were identified. In the total study population, the ratio of observed and expected number of hip fracture for women was 1.99 (95% CI 1.39-2.75) and for men 2.54 (95% CI 1.91-3.31). The corresponding ratio for MOF in women was 1.36 (CI 1.18-1.56) and for men 1.61 (CI 1.37-1.88). From 2005 onwards, when differentiation in the registry between allo- and auto-HSCT was possible, the observed number of hip fracture and MOF in allo-HSCT (n = 1865) were significantly increased (observed/expected hip fracture 5.24 (95% CI 3.28-7.93) and observed/expected MOF 2.08 (95% CI 1.63-2.62)). Fractures occurred in mean 2.7 (hip) and 2.5 (MOF) years after allo-HSCT. Graft-versus-host disease (GVHD) was not associated with an increased risk of fracture.
CONCLUSIONS: Patients who underwent HSCT had an increased risk of both hip and major osteoporotic fracture compared with the Swedish population and occurred in 4.3% of patients. GVHD was not statistically significantly associated with fracture risk.
OBJECTIVE: To explore the risk for osteoporotic fracture in patients who have undergone hematopoietic stem cell transplantation (HSCT) compared with the Swedish population.
METHODS: The risk of osteoporotic fractures was determined in a retrospective population cohort study of adult (≥ 18 years) Swedish patients (n = 8463), who were transplanted with HSCT 1997-2016 and compared with all adults living in Sweden during the same period.
RESULTS: In the total study group (n = 8463), 90 hip fractures (1.1% both in males and females) and 361 major osteoporotic fractures (MOF) (3.2% in men and 6.0% in women) were identified. In the total study population, the ratio of observed and expected number of hip fracture for women was 1.99 (95% CI 1.39-2.75) and for men 2.54 (95% CI 1.91-3.31). The corresponding ratio for MOF in women was 1.36 (CI 1.18-1.56) and for men 1.61 (CI 1.37-1.88). From 2005 onwards, when differentiation in the registry between allo- and auto-HSCT was possible, the observed number of hip fracture and MOF in allo-HSCT (n = 1865) were significantly increased (observed/expected hip fracture 5.24 (95% CI 3.28-7.93) and observed/expected MOF 2.08 (95% CI 1.63-2.62)). Fractures occurred in mean 2.7 (hip) and 2.5 (MOF) years after allo-HSCT. Graft-versus-host disease (GVHD) was not associated with an increased risk of fracture.
CONCLUSIONS: Patients who underwent HSCT had an increased risk of both hip and major osteoporotic fracture compared with the Swedish population and occurred in 4.3% of patients. GVHD was not statistically significantly associated with fracture risk.
摘要：
在这项成人干细胞移植患者（n=8463）的回顾性队列研究中，与瑞典人群相比,MOF和髋部骨折的风险显著增加,并且平均发生在干细胞移植后2年以上.
目的：探讨与瑞典人群相比，接受造血干细胞移植（HSCT）的患者发生骨质疏松性骨折的风险。
方法：在一项针对瑞典成年（≥18岁）患者（n=8463）的回顾性人群队列研究中确定了骨质疏松性骨折的风险，他们在1997-2016年进行了HSCT移植，并与同期生活在瑞典的所有成年人进行了比较。
结果：在总研究组（n=8463）中，发现90例髋部骨折（男性和女性均为1.1％）和361例严重骨质疏松性骨折（MOF）（男性为3.2％，女性为6.0％）。在整个研究人群中,女性髋部骨折观察数与预期数的比值为1.99(95%CI1.39~2.75),男性为2.54(95%CI1.91~3.31).女性MOF的相应比率为1.36（CI1.18-1.56），男性为1.61（CI1.37-1.88）。从2005年起,当在注册表中可以区分allot-HSCT和auto-HSCT时，allo-HSCT中观察到的髋部骨折和MOF数量(n=1865)显著增加(观察/预期髋部骨折5.24(95%CI3.28-7.93)和观察/预期MOF2.08(95%CI1.63-2.62)).allo-HSCT后平均2.7年（髋部）和2.5年（MOF）发生骨折。移植物抗宿主病（GVHD）与骨折风险增加无关。
结论：与瑞典人群相比，接受HSCT的患者发生髋部和严重骨质疏松性骨折的风险增加，发生率为4.3%。GVHD与骨折风险无统计学意义。
目的：探讨与瑞典人群相比，接受造血干细胞移植（HSCT）的患者发生骨质疏松性骨折的风险。
方法：在一项针对瑞典成年（≥18岁）患者（n=8463）的回顾性人群队列研究中确定了骨质疏松性骨折的风险，他们在1997-2016年进行了HSCT移植，并与同期生活在瑞典的所有成年人进行了比较。
结果：在总研究组（n=8463）中，发现90例髋部骨折（男性和女性均为1.1％）和361例严重骨质疏松性骨折（MOF）（男性为3.2％，女性为6.0％）。在整个研究人群中,女性髋部骨折观察数与预期数的比值为1.99(95%CI1.39~2.75),男性为2.54(95%CI1.91~3.31).女性MOF的相应比率为1.36（CI1.18-1.56），男性为1.61（CI1.37-1.88）。从2005年起,当在注册表中可以区分allot-HSCT和auto-HSCT时，allo-HSCT中观察到的髋部骨折和MOF数量(n=1865)显著增加(观察/预期髋部骨折5.24(95%CI3.28-7.93)和观察/预期MOF2.08(95%CI1.63-2.62)).allo-HSCT后平均2.7年（髋部）和2.5年（MOF）发生骨折。移植物抗宿主病（GVHD）与骨折风险增加无关。
结论：与瑞典人群相比，接受HSCT的患者发生髋部和严重骨质疏松性骨折的风险增加，发生率为4.3%。GVHD与骨折风险无统计学意义。
