BACKGROUND: The prevalence of vertebral deformities in long-term survivors of childhood acute lymphoblastic leukemia (ALL) is unknown. Our objectives were to identify the prevalence of vertebral deformities and their risk factors among long-term childhood ALL survivors. METHODS/ RESULTS: We recruited 245 (49% male) long-term childhood ALL survivors from the Preventing Late Adverse Effects of Leukemia Cohort (French-Canadian ALL survivors treated between the years 1987 and 2010 with the Dana Farber Cancer Institute clinical trials protocols, who did not experience disease relapse and/or receive hematopoietic stem cell transplant). Median age at recruitment was 21.7 years (range, 8.5-41) and median time since diagnosis was 15.1 years (range, 5.4-28.2). All participants underwent spine radiograph and dual-energy X-ray absorptiometry scans. The prevalence of vertebral deformity was 23% with 88% classified as grade 1 according to the Genant method. The majority of vertebral deformities were clinically silent. Regression analysis confirmed male sex (risk ratio [RR] = 1.94; 95% confidence interval [CI], 1.16-3.24; P = 0.011), higher glucocorticoid cumulative dose (RR = 1.05; 95% CI, 1.00-1.10; P = 0.032), and back pain (RR = 2.44; 95% CI, 1.56-3.84; P < 0.001) as predictors of prevalent vertebral deformity. Sex differences in vertebral deformity predictors emerged. CONCLUSIONS: We report a significant prevalence of vertebral deformities in this young cohort. Male sex, cumulative glucocorticoid dose, and back pain were identified as predictors of prevalent vertebral deformity. Back pain emerging as a strong predictor of vertebral deformity underscores the importance of ongoing bone health surveillance in survivors with persistent vertebral deformities treated with these earlier protocols.
BACKGROUND: The prevalence of vertebral deformities in long-term survivors of childhood acute lymphoblastic leukemia (ALL) is unknown. Our objectives were to identify the prevalence of vertebral deformities and their risk factors among long-term childhood ALL survivors. METHODS/ RESULTS: We recruited 245 (49% male) long-term childhood ALL survivors from the Preventing Late Adverse Effects of Leukemia Cohort (French-Canadian ALL survivors treated between the years 1987 and 2010 with the Dana Farber Cancer Institute clinical trials protocols, who did not experience disease relapse and/or receive hematopoietic stem cell transplant). Median age at recruitment was 21.7 years (range, 8.5-41) and median time since diagnosis was 15.1 years (range, 5.4-28.2). All participants underwent spine radiograph and dual-energy X-ray absorptiometry scans. The prevalence of vertebral deformity was 23% with 88% classified as grade 1 according to the Genant method. The majority of vertebral deformities were clinically silent. Regression analysis confirmed male sex (risk ratio [RR] = 1.94; 95% confidence interval [CI], 1.16-3.24; P = 0.011), higher glucocorticoid cumulative dose (RR = 1.05; 95% CI, 1.00-1.10; P = 0.032), and back pain (RR = 2.44; 95% CI, 1.56-3.84; P < 0.001) as predictors of prevalent vertebral deformity. Sex differences in vertebral deformity predictors emerged. CONCLUSIONS: We report a significant prevalence of vertebral deformities in this young cohort. Male sex, cumulative glucocorticoid dose, and back pain were identified as predictors of prevalent vertebral deformity. Back pain emerging as a strong predictor of vertebral deformity underscores the importance of ongoing bone health surveillance in survivors with persistent vertebral deformities treated with these earlier protocols.
Authors: N Alos; M Krajinovic; A Shalmiev; G Nadeau; M Aaron; E Ouimet-Grennan; S Drouin; L Bertout; P Beaulieu; P St-Onge; L-N Veilleux; F Rauch; A Rezgui; K Petrykey; C Laverdière; D Sinnett Journal: Pharmacogenomics J Date: 2021-08-26 Impact factor: 3.550
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