Fracture risk prediction using FRAX in patients following hematopoietic stem cell transplantation

Xerxes Nozer Pundole, William A Murphy Jr, Chidinma C. Ebede, Erfan Karim, Srishti Manocha, Data Don-Pedro, Gabriela Rondon, Cheuk Hong Leung, Suyu Liu, Xianglin L. Du, Richard E Champlin, Huifang Lu

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Article number38
JournalArchives of Osteoporosis
Volume13
Issue number1
DOIs
StatePublished - Dec 1 2018

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Hematopoietic Stem Cell Transplantation
Osteoporotic Fractures
Aptitude
Odds Ratio
Confidence Intervals
Transplants
Proportional Hazards Models
Decision Making
Neoplasms

Keywords

  • FRAX
  • Fracture
  • Osteoporosis
  • Stem cell transplant

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Fracture risk prediction using FRAX in patients following hematopoietic stem cell transplantation. / Pundole, Xerxes Nozer; Murphy Jr, William A; Ebede, Chidinma C.; Karim, Erfan; Manocha, Srishti; Don-Pedro, Data; Rondon, Gabriela; Leung, Cheuk Hong; Liu, Suyu; Du, Xianglin L.; Champlin, Richard E; Lu, Huifang.

In: Archives of Osteoporosis, Vol. 13, No. 1, 38, 01.12.2018.

Research output: Contribution to journalArticle

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title = "Fracture risk prediction using FRAX in patients following hematopoietic stem cell transplantation",
abstract = "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.",
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AU - Pundole, Xerxes Nozer

AU - Murphy Jr, 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

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

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KW - Osteoporosis

KW - Stem cell transplant

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