A.I. Burnasyan FMBC clinical bulletin. 2025 № 1
K.M. Badykova1, Y.S. Kitaeva2, E.A. Praskurnichij1, E.V. Kuzneczova3, M.A. Butusova1, V.S. Blinov4
Staged Treatment of a Femoral Neck Fracture Due to Osteoporosis Associated
with Hemoblastosis: Description of a Clinical Case Study
1International Office, State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russiа
2Department of Analysis and Strategic Planning of the Center for Public Health and Medical Prevention of the FMBA of Russia, Moscow, Russia
3Ural State Medical University, Ministry of Health of the Russian Federation, Ekaterinburg, Russia
4Verkhnepyshminskaya Central City Hospital named after P.D. Borodin, Sverdlovsk Region, Russia
Contact person: Badykova Kseniya Mikhaylovna: t_astrelina@mail.ru
Abstract
Osteoporosis can develop from a variety of conditions. Today, this pathology is increasingly acquiring medical and social significance and is spreading to young people. An important pathogenetic link in drug-induced osteoporosis is pathogenetic therapy in the treatment of hematologic malignancies, such as acute myeloid leukemia. The condition of the bone tissue is influenced by the course of the underlying disease and the toxic effect of chemotherapy, which helps to increase the activity of osteoresorptive processes. The problem of the development of osteoporosis in patients with acute myeloid leukemia after courses of high-dose pathogenetic therapy is very relevant. We describe a clinical case of a patient diagnosed with acute myeloid leukemia who received induction courses of chemotherapy and developed a closed medial fracture of the right femoral neck as a result of treatment. After the fracture, the patient received an allogeneic hematopoietic stem cell transplant. The patient received immunosuppressive therapy as part of the prevention of graft-versus-host disease. After transplantation, the patient underwent cemented total hip arthroplasty of the right hip joint. The bone tissue condition in this case was assessed using dual-energy X-ray absorptiometry, according to which the patient had osteopenia/osteoporosis. Despite the severity of the underlying disease, allogeneic hematopoietic stem cell transplantation and ongoing immunosuppressive therapy, the patient underwent surgery satisfactorily, without complications. This clinical case shows the importance of early diagnosis and timely initiation of osteoporosis prevention in this category of patients in order to prevent the development of severe complications.
Keywords: acute myeloid leukemia, osteoporosis, densitometry, pathological fracture, allogeneic hematopoietic stem cell transplantation
For citation: Badykova KM, Kitaeva YS, Praskurnichij EA, Kuzneczova EV, Butusova MA, Blinov VS. Staged Treatment of a Femoral Neck Fracture Due to Osteoporosis Associated with Hemoblastosis: Description of a Clinical Case Study. A.I. Burnasyan Federal Medical Biophysical Center Clinical Bulletin. 2025.1:42-48. (In Russian) DOI: 10.33266/2782-6430-2025-1-42-48
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Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 11.09.2024. Accepted for publication: 15.10.2024