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Osteopenia/osteoporosis (O/O) has been associated with allogeneic stem cell transplantation (alloSCT). We retrospectively reviewed 102 patients undergoing a first alloSCT from 2000 to 2005 at our center to evaluate the prevalence of O/O 6 and >6 months post-alloSCT. Fifty-six patients did not have a dual energy X-ray absorptiometry (DXA) scan following alloSCT. Approximately half (n=13/27) of those with a first DXA scan 6 months post-alloSCT had O/O and a similar rate (n=9/19) was seen in those with a first DXA scan >6 months. There were no significant differences in patient characteristics between the normal and O/O groups. The dual femur (DF) appeared to be more vulnerable to alloSCT-induced bone mineral density (BMD) loss than the lumbar spine (LS), regardless of screening time. O/O patients were treated with bisphosphonates and 41% had a repeat DXA scan post-treatment. No patient developed jaw osteonecrosis and significant BMD improvement was seen at the LS (mean BMD, 1.03±0.13 vs 1.08±0.12, P=0.004) but not the DF (mean BMD, 0.84±0.06 vs 0.85±0.08, P=0.29), indicating BMD loss at the DF is more resistant than the LS to antiresorptive therapy. Our results demonstrate that O/O is an early and late complication post-alloSCT and bisphosphonate treatment reverses BMD loss at the LS.Bone Marrow Transplantation (2008) 41, 393–398; doi:10.1038/sj.bmt.1705918; published online 12 November 2007 [ABSTRACT FROM AUTHOR]

Tacrolimus (Prograf®, FK506, Fujisawa Healthcare) is a widely used immunosuppressive agent that is used both for the prevention and treatment of solid organ transplant rejection as well as for the prevention and treatment of graft-versus-host disease after allogeneic blood and marrow transplant. Oral preparations of tacrolimus are commercially available in 0.5, 1 and 5 mg gelatin capsules. Previously, only a 0.5 mg/ml oral suspension has been demonstrated to be stable for use in pediatric patients. On our bone marrow transplant service, we found that using this concentration of tacrolimus led to confusion, with patients and their caregivers confusing milligrams and milliliters, thus increasing errors with this formulation. We postulated that a 1 mg/ml oral formulation of tacrolimus would decrease the potential for medication errors. Our findings support new stability information of approximately 4 months for an extemporaneous oral suspension of tacrolimus at a concentration of 1 mg/ml.Bone Marrow Transplantation (2006) 37, 781–784. doi:10.1038/sj.bmt.1705320; published online 6 March 2006 [ABSTRACT FROM AUTHOR]

The article presents a case study of a 51-year-old woman presented to bone marrow transplant service for management of advanced stage myeloproliferative neoplasm (MPN) with mycosis fungoide (MF) and pancytopenia. The computerized tomography examination of the patient revealed transfusion-dependent anemia. The autologous reconstitution led to sustained JAK2-V617F negativity post allogeneic hematopoietic stem cell transplant.

A letter to the editor is presented which discusses the report on three cases of fatal lung toxicity in allogeneic hematopoietic cell transplantation (alloHCT) patients which receives Sirolimus (SRL).

The article presents a case study of a 40-year-old white man with precursor B-cell acute lymphoblastic leukemia (ALL). The patient was then introduced with histocompatibility leukocyte antigen (HLA)-matched allogeneic haematopoietic stem cell transplantation (HSCT) after it was found out after biopsy that he had hypoplasia. However, after seven months of HSCT, a flank mass was observed and diagnosed as extra-medullary relapse of ALL.