Treatment of thalassemia-induced osteoporosis with intermittent pamidronate infusions: Two-year follow up.

OBJECTIVE The purpose of this study was to evaluate the bone mineral density (BMD) in 23 patients aged 7-14 years with thalassemia major and to assess the alterations in bone density in a two-year follow-up study. METHOD BMD of the lumbar spine and femoral neck was determined by dual-energy X-ray absorptiometry (DXA) at baseline, after 12 months of treatment and two years later. Pamidronate treatment (15 mg/dose, every 3 months for 1 year) was given to 23 osteoporotic (Z score below -2.5) and osteopenic (Z score -1 to -2.5) patients. After 12 months of treatment, all patients received only calcium and vitamin D supplements. After the two years of follow-up, BMD of the lumbar spine and femur was measured using DXA. RESULT Administration of pamidronate resulted in a significant increase in BMD of the femoral neck. Lumbar spine BMD after pamidronate treatment was slightly higher than at baseline, but this was statistically non-significant. After two years, femoral neck and lumbar BMD had significantly increased compared to baseline. CONCLUSION In view of the present findings, longer follow-up studies to determine long-term treatment are fully warranted.