SUMMARY: More than 45 % of long-term childhood cancer survivors (CCS) were diagnosed with osteopenia. Our data suggest that greater awareness for osteopenia is warranted in long-term CCS, especially in survivors who are older than 30 years, male, and underweight and were treated with cranial-spinal radiotherapy and/or steroids. INTRODUCTION: Osteopenia is a potential complication of childhood cancer treatment, but the magnitude of this problem in survivors is unknown. We examined (determinants of) bone mineral density (BMD) status in long-term survivors of adult childhood cancer. METHODS: This retrospective single-centre cohort study included 346 subjects with the most common types of childhood cancer. Subjects had a median age at diagnosis of 7.0 years (range 0.1-16.8 years), a median age at follow-up of 24.5 years (range 18.0-47.6 years) and a median follow-up time of 16.7 years (range 5.6-39.9 years). Total body BMD (BMDTB) and BMD of the lumbar spine (BMDLS) were measured by dual X-ray absorptiometry. Osteopenia was defined as BMD standardized deviation score (SDS) below -1. RESULTS: Survivors had a lower BMDTB and BMDLS (mean SDS -0.55; p<0.001 and -0.30; p<0.001, respectively) as compared to healthy peers. Osteopenia (BMDTB and/or BMDLS) was present in 45% of the survivors. Multivariate logistic regression analyses identified age at diagnosis<12 years, age>30 years at follow-up, male gender, underweight at follow-up and treatment with cranial-spinal radiotherapy or prednisone as independent prognostic factors for osteopenia. CONCLUSIONS: This large cohort of childhood cancer survivors identified osteopenia in 45% of CCS. This indicates that greater awareness is warranted, especially in survivors who are older than 30 years, male, have underweight and were treated with cranial-spinal radiotherapy and/or steroids.
SUMMARY: More than 45 % of long-term childhood cancer survivors (CCS) were diagnosed with osteopenia. Our data suggest that greater awareness for osteopenia is warranted in long-term CCS, especially in survivors who are older than 30 years, male, and underweight and were treated with cranial-spinal radiotherapy and/or steroids. INTRODUCTION:Osteopenia is a potential complication of childhood cancer treatment, but the magnitude of this problem in survivors is unknown. We examined (determinants of) bone mineral density (BMD) status in long-term survivors of adult childhood cancer. METHODS: This retrospective single-centre cohort study included 346 subjects with the most common types of childhood cancer. Subjects had a median age at diagnosis of 7.0 years (range 0.1-16.8 years), a median age at follow-up of 24.5 years (range 18.0-47.6 years) and a median follow-up time of 16.7 years (range 5.6-39.9 years). Total body BMD (BMDTB) and BMD of the lumbar spine (BMDLS) were measured by dual X-ray absorptiometry. Osteopenia was defined as BMD standardized deviation score (SDS) below -1. RESULTS: Survivors had a lower BMDTB and BMDLS (mean SDS -0.55; p<0.001 and -0.30; p<0.001, respectively) as compared to healthy peers. Osteopenia (BMDTB and/or BMDLS) was present in 45% of the survivors. Multivariate logistic regression analyses identified age at diagnosis<12 years, age>30 years at follow-up, male gender, underweight at follow-up and treatment with cranial-spinal radiotherapy or prednisone as independent prognostic factors for osteopenia. CONCLUSIONS: This large cohort of childhood cancer survivors identified osteopenia in 45% of CCS. This indicates that greater awareness is warranted, especially in survivors who are older than 30 years, male, have underweight and were treated with cranial-spinal radiotherapy and/or steroids.
Authors: S C Kaste; D Jones-Wallace; S R Rose; J M Boyett; R H Lustig; G K Rivera; C H Pui; M M Hudson Journal: Leukemia Date: 2001-05 Impact factor: 11.528
Authors: Annemieke M Boot; Maria A J de Ridder; Inge M van der Sluis; Ingrid van Slobbe; Eric P Krenning; Sabine M P F de Muinck Keizer-Schrama Journal: Bone Date: 2009-10-13 Impact factor: 4.398
Authors: H L Müller; P Schneider; K Bueb; N Etavard-Gorris; U Gebhardt; R Kolb; N Sörensen Journal: Exp Clin Endocrinol Diabetes Date: 2003-05 Impact factor: 2.949
Authors: S Lie Fong; P J Lugtenburg; I Schipper; A P N Themmen; F H de Jong; P Sonneveld; J S E Laven Journal: Hum Reprod Date: 2008-01-23 Impact factor: 6.918
Authors: Robert D van Beek; Marry M van den Heuvel-Eibrink; Joop S E Laven; Frank H de Jong; Axel P N Themmen; Friederike G Hakvoort-Cammel; Cor van den Bos; Henk van den Berg; Rob Pieters; Sabine M P F de Muinck Keizer-Schrama Journal: J Clin Endocrinol Metab Date: 2007-08-28 Impact factor: 5.958
Authors: Yun Jung Choi; Sun Young Park; Won Kyoung Cho; Jae Wook Lee; Kyoung Soon Cho; So Hyun Park; Seung Hoon Hahn; Min Ho Jung; Nack Gyun Chung; Bin Cho; Byung Kyu Suh; Hack Ki Kim Journal: J Korean Med Sci Date: 2013-10-31 Impact factor: 2.153
Authors: Marissa A H den Hoed; Saskia M F Pluijm; Mariël L te Winkel; Hester A de Groot-Kruseman; Martha Fiocco; Peter Hoogerbrugge; Jan A Leeuw; Marrie C A Bruin; Inge M van der Sluis; Dorien Bresters; Maarten H Lequin; Jan C Roos; Anjo J P Veerman; Rob Pieters; Marry M van den Heuvel-Eibrink Journal: Haematologica Date: 2015-09-24 Impact factor: 9.941
Authors: Cindy Im; Nan Li; Wonjong Moon; Qi Liu; Lindsay M Morton; Wendy M Leisenring; Rebecca M Howell; Eric J Chow; Charles A Sklar; Carmen L Wilson; Zhaoming Wang; Yadav Sapkota; Wassim Chemaitilly; Kirsten K Ness; Melissa M Hudson; Leslie L Robison; Smita Bhatia; Gregory T Armstrong; Yutaka Yasui Journal: J Bone Miner Res Date: 2020-12-30 Impact factor: 6.741
Authors: Jenneke E van Atteveld; Saskia M F Pluijm; Kirsten K Ness; Melissa M Hudson; Wassim Chemaitilly; Sue C Kaste; Leslie L Robison; Sebastian J C M M Neggers; Yutaka Yasui; Marry M van den Heuvel-Eibrink; Carmen L Wilson Journal: J Clin Oncol Date: 2019-05-31 Impact factor: 50.717
Authors: Jenneke E van Atteveld; Iris E Verhagen; Marry M van den Heuvel-Eibrink; Hanneke M van Santen; Inge M van der Sluis; Natascia Di Iorgi; Jill H Simmons; Leanne M Ward; Sebastian J C M M Neggers Journal: Cancer Med Date: 2021-06-08 Impact factor: 4.452
Authors: Jenneke E van Atteveld; Renée L Mulder; Marry M van den Heuvel-Eibrink; Melissa M Hudson; Leontien C M Kremer; Roderick Skinner; W Hamish Wallace; Louis S Constine; Claire E Higham; Sue C Kaste; Riitta Niinimäki; Sogol Mostoufi-Moab; Nathalie Alos; Danilo Fintini; Kimberly J Templeton; Leanne M Ward; Eva Frey; Roberto Franceschi; Vesna Pavasovic; Seth E Karol; Nadia L Amin; Lynda M Vrooman; Arja Harila-Saari; Charlotte Demoor-Goldschmidt; Robert D Murray; Edit Bardi; Maarten H Lequin; Maria Felicia Faienza; Olga Zaikova; Claire Berger; Stefano Mora; Kirsten K Ness; Sebastian J C M M Neggers; Saskia M F Pluijm; Jill H Simmons; Natascia Di Iorgi Journal: Lancet Diabetes Endocrinol Date: 2021-07-30 Impact factor: 44.867