Bone remodeling in survivors of pediatric hematopoietic stem cell transplantation: Impact of heavy resistance training

Abstract

Background: Early-onset osteoporosis is a frequent late effect after pediatric hematopoietic stem cell transplantation (HSCT). It remains unknown if physical training can improve bone formation in these patients, as the transplantation procedure may cause sustained dysregulation of the bone-forming osteoblast progenitor cells. Objective: We aimed to explore the effect of resistance training on bone remodeling in long-term survivors of pediatric HSCT. Procedure: In this prospective, controlled intervention study, we included seven HSCT survivors and 15 age- and sex-matched healthy controls. The participants completed a 12-week heavy load, lower extremity resistance training intervention with three weekly sessions. We measured fasting serum levels of the bone formation marker “N-terminal propeptide of type I procollagen” (P1NP), and the bone resorption marker “C-terminal telopeptide of type I collagen” (CTX). The hypothesis was planned before data collection began. The trial was registered at Clinicaltrials.gov before including the first participant, with trial registration no. NCT04922970. Results: Resistance training led to significantly increased levels of fasting P1NP in both patients (from 57.62 to 114.99 ng/mL, p =.03) and controls (from 66.02 to 104.62 ng/mL, p