Staged Treatment of a Femoral Neck Fracture Due to Osteoporosis Associated with Hemoblastosis: Description of a Clinical Case Study

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.