TY - JOUR
T1 - Fracture risk prediction using FRAX in patients following hematopoietic stem cell transplantation
AU - Pundole, Xerxes
AU - Murphy, William A.
AU - Ebede, Chidinma C.
AU - Karim, Erfan
AU - Manocha, Srishti
AU - Don-Pedro, Data
AU - Rondon, Gabriela
AU - Leung, Cheuk Hong
AU - Liu, Suyu
AU - Du, Xianglin L.
AU - Champlin, Richard E.
AU - Lu, Huifang
N1 - Publisher Copyright:
© 2018, International Osteoporosis Foundation and National Osteoporosis Foundation.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Summary: We aimed to study the utility of the FRAX tool in predicting fractures in patient’s receiving a hematopoietic stem cell transplantation (HSCT). Our results indicate that the FRAX tool has modest fracture predictive ability in patients greater than 50 years of age at the time of HSCT. Purpose: Identifying patients at high risk of osteoporotic fractures following HSCT is challenging. We aimed to evaluate the utility of the FRAX tool at the time of HSCT in predicting fractures following transplant. Methods: We conducted a retrospective chart review of adults (> 18 years) who underwent HSCT at MD Anderson Cancer Center from January 1, 2001, to December 31, 2010, and were followed until December 31, 2013, to identify osteoporotic fractures. Multivariate Cox regression models were built using FRAX score thresholds of low risk < 10%, medium risk 10 to 20%, and high risk > 20% probability of osteoporotic fracture. Results: We identified 5170 patients who had undergone HSCT, 10% of whom developed an osteoporotic fracture during a median follow-up of 3.2 years. In patients > 65 years of age, those with medium risk (hazard ratio (HR) 2.38, 95% confidence interval (CI) 1.27–4.47) and high risk (HR 3.41, 95% CI 1.73–6.75) had a greater probability of developing an osteoporotic fracture compared to those at low risk. Similar trends were seen in patients 50 to 65 years of age. Conclusions: In patients greater than 50 years, the FRAX tool has modest predictive ability and could be used to aid in preventive treatment decision-making at the time of transplant.
AB - Summary: We aimed to study the utility of the FRAX tool in predicting fractures in patient’s receiving a hematopoietic stem cell transplantation (HSCT). Our results indicate that the FRAX tool has modest fracture predictive ability in patients greater than 50 years of age at the time of HSCT. Purpose: Identifying patients at high risk of osteoporotic fractures following HSCT is challenging. We aimed to evaluate the utility of the FRAX tool at the time of HSCT in predicting fractures following transplant. Methods: We conducted a retrospective chart review of adults (> 18 years) who underwent HSCT at MD Anderson Cancer Center from January 1, 2001, to December 31, 2010, and were followed until December 31, 2013, to identify osteoporotic fractures. Multivariate Cox regression models were built using FRAX score thresholds of low risk < 10%, medium risk 10 to 20%, and high risk > 20% probability of osteoporotic fracture. Results: We identified 5170 patients who had undergone HSCT, 10% of whom developed an osteoporotic fracture during a median follow-up of 3.2 years. In patients > 65 years of age, those with medium risk (hazard ratio (HR) 2.38, 95% confidence interval (CI) 1.27–4.47) and high risk (HR 3.41, 95% CI 1.73–6.75) had a greater probability of developing an osteoporotic fracture compared to those at low risk. Similar trends were seen in patients 50 to 65 years of age. Conclusions: In patients greater than 50 years, the FRAX tool has modest predictive ability and could be used to aid in preventive treatment decision-making at the time of transplant.
KW - FRAX
KW - Fracture
KW - Osteoporosis
KW - Stem cell transplant
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U2 - 10.1007/s11657-018-0453-5
DO - 10.1007/s11657-018-0453-5
M3 - Article
C2 - 29619576
AN - SCOPUS:85044936018
SN - 1862-3522
VL - 13
JO - Archives of Osteoporosis
JF - Archives of Osteoporosis
IS - 1
M1 - 38
ER -