Long-Term Effects of Pamidronate in Thalassemic Patients with Severe Bone Mineral Density Deficits

Abstract

Osteoporosis is a common complication in thalassemia major (TM). Our previous study demonstrated severe bone mineral density (BMD) deficits at spine and hip in 62 and 35% of TM patients. This study assessed the effects of different treatments (calcium, vitamin D and bisphosphonate) on patients' BMD, which was measured at baseline and after 3-year treatments by dual energy X-ray absorptiometry (DEXA). Twenty-one untreated patients, 11 patients on calcium/vitamin D and seven patients on additional pamidronate, were recruited. They were comparable for gender (p = 0.630) and serum ferritin levels (p = 0.412). The median BMD Z-scores at lumbar spine and left hip improved only in patients with standard plus pamidronate treatments (baseline: −3.01 and −3.05, end-of-study: −2.12 and −2.09; p = 0.018 and 0.028, respectively). In contrast, BMD Z-scores at hip worsened in untreated patients (p = 0.034). In conclusion, long-term improvement in BMD in TM patients was observed with bisphosphonate but not calcium and vitamin D treatment.

Keywords:

• Bisphosphonate
• Bone mineral density (BMD)
• Osteoporosis
• Thalassemia major (TM)
• Treatment

ACKNOWLEDGMENTS

We thank Ms. Chung Yi Li (Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, People's Republic of China) for her assistance in measuring the BMD for our patients.

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.