Manifestaciones osteomusculares en pacientes sometidos a trasplante alogénico de progenitores hematopoyéticos

García-López, A.; Fernández-Delgado, C.; Hernández-Sánchez, R.; Uceda, J.; Parody, R.

doi:10.1016/S1699-258X(05)72723-6

Article information

Objetivo

Hay pocos estudios sobre las manifestaciones osteomusculares tras un trasplante alogénico de progenitores hematopoyéticos (TPH-ALO). El objetivo del presente estudio es investigar los síntomas osteomusculares observados tras la realización de un TPH-ALO como tratamiento de distintas enfermedades hematológicas y no hematológicas.

Material y métodos

Estudio observacional retrospectivo, realizado mediante la revisión de historias clínicas.

Resultados

Desde el año 1996 hasta el 2000 se identificó a 123 pacientes sometidos a un TPH-ALO, 34 niños (5 meses-14 años) y 81 adultos (15-55 años). La distribución por sexos fue la siguiente: 48 mujeres (39%) y 75 varones (61%). De estos pacientes, 43 (34,90%) presentaron enfermedad del injerto contra el huésped (EICH) aguda, 33 de 106 (31,1%) presentaron EICH crónica y 50 de los pacientes (40,65%) murieron durante el seguimiento. Catorce (13,2%) presentaron manifestaciones osteomusculares: 6 (5,6%) necrosis aséptica, 5 (4,7%) esclerodermia, uno artralgias y bronquiolitis obliterante, uno poliartralgias y otro monoartritis de rodilla.

Conclusiones

Es difícil atribuir los síntomas osteomusculares tras un TPH-ALO a una sola causa. Las manifestaciones inflamatorias y fibrosantes pueden ocurrir debido al proceso inflamatorio de la EICH crónica o por los tratamientos administrados durante el procedimiento.

Palabras clave:

Progenitores hematopoyéticos

Trasplante alogénico

Enfermedad del injerto contra el huésped

Introduction

Few studies have examined musculoskeletal manifestations after allogenic hematopoietic stem cell transplantation (AHSCT).

Objective

To investigate the musculoskeletal symptoms observed after AHSCT for distinct hematological and non-hematological diseases.

Material and methods

We performed a retrospective, observational study through review of medical records.

Results

There were 123 patients who underwent AHSCT from 1996 to 2000: 34 children (aged 5 months-14 years) and 81 adults (aged 15-55 years). There were 48 women (39%) and 75 men (61%). Of these patients, 43 (34.90%) had acute graft-versus-host disease (aGVHD). Thirty-three out of 106 patients (31.1%) had chronic GVHD (cGVDH) and 50 patients (40.65%) died during follow-up. Musculoskeletal manifestations were found in 14 patients (13.2%): aseptic necrosis in six (5.6%), scleroderma in five (4.7%), arthralgia and bronchiolitis obliterans in one, polyarthralgia in one, and knee monoarthritis in one.

Conclusions

Musculoskeletal manifestations after AHSCT cannot be attributed to a single cause. Inflammatory and fibrosing manifestations can be due to the inflammatory process of cGVHD or to the treatments administered during transplantation.

Key words:

hematopoietic stem cells

Allogenic transplantation

Graft-versus-host disease

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