PURPOSE: Osteoporosis and pathologic fractures are occasionally found in patients with childhood acute lymphoblastic leukemia (ALL). This study was performed to determine the degree of possible osteopenia in long-term survivors of childhood ALL. PATIENTS AND METHODS: Lumbar spine (L2-L4) and femoral neck bone mineral densities (BMDs) (g/cm2) were measured in 29 survivors (aged 12 to 30 years, median 17) of childhood ALL 2 to 20 (median 8) years after discontinuation of chemotherapy. These results were compared with those from 273 healthy controls and expressed as a percentage of the age- and sex-matched control values (mean +/- standard deviation). RESULTS: Lumbar and femoral BMDs were significantly reduced in survivors of childhood ALL. Particularly, male gender (lumbar: 91.7 +/- 10.4%, p = 0.008; femoral: 91.9 +/- 11.3%, p = 0.005) and a history of cranial irradiation (lumbar: 93.0 +/- 8.9%, p = 0.005; femoral: 94.4 +/- 13.3%, p = 0.03) were associated with low lumbar and femoral BMDs. CONCLUSIONS: The detected deficit in bone density in survivors of childhood ALL may predispose these patients to osteoporotic fractures later in adulthood. A follow-up of BMD in survivors of childhood ALL should facilitate the identification of patients who would require specific therapeutic interventions to prevent further decrease of their skeletal mass and preserve their BMD.
PURPOSE:Osteoporosis and pathologic fractures are occasionally found in patients with childhood acute lymphoblastic leukemia (ALL). This study was performed to determine the degree of possible osteopenia in long-term survivors of childhood ALL. PATIENTS AND METHODS: Lumbar spine (L2-L4) and femoral neck bone mineral densities (BMDs) (g/cm2) were measured in 29 survivors (aged 12 to 30 years, median 17) of childhood ALL 2 to 20 (median 8) years after discontinuation of chemotherapy. These results were compared with those from 273 healthy controls and expressed as a percentage of the age- and sex-matched control values (mean +/- standard deviation). RESULTS: Lumbar and femoral BMDs were significantly reduced in survivors of childhood ALL. Particularly, male gender (lumbar: 91.7 +/- 10.4%, p = 0.008; femoral: 91.9 +/- 11.3%, p = 0.005) and a history of cranial irradiation (lumbar: 93.0 +/- 8.9%, p = 0.005; femoral: 94.4 +/- 13.3%, p = 0.03) were associated with low lumbar and femoral BMDs. CONCLUSIONS: The detected deficit in bone density in survivors of childhood ALL may predispose these patients to osteoporotic fractures later in adulthood. A follow-up of BMD in survivors of childhood ALL should facilitate the identification of patients who would require specific therapeutic interventions to prevent further decrease of their skeletal mass and preserve their BMD.
Authors: J G Gurney; S C Kaste; W Liu; D K Srivastava; W Chemaitilly; K K Ness; J Q Lanctot; R P Ojha; K A Nottage; C L Wilson; Z Li; L L Robison; M M Hudson Journal: Pediatr Blood Cancer Date: 2014-02-28 Impact factor: 3.167
Authors: Shesh N Rai; Melissa M Hudson; Elizabeth McCammon; Laura Carbone; Francis Tylavsky; Karen Smith; Harriet Surprise; John Shelso; Chin-Hon Pui; Sue Kaste Journal: Contemp Clin Trials Date: 2008-05-18 Impact factor: 2.226
Authors: Sue C Kaste; Monika L Metzger; Anum Minhas; Zang Xiong; Shesh N Rai; Kirsten K Ness; Melissa M Hudson Journal: Pediatr Blood Cancer Date: 2009-04 Impact factor: 3.167
Authors: Melinda R Stolley; Lisa K Sharp; Claudia Arroyo; Cherese Ruffin; Jacqueline Restrepo; Richard Campbell Journal: Cancer Date: 2009-09-15 Impact factor: 6.860
Authors: Inas H Thomas; Janet E Donohue; Kirsten K Ness; Donald R Dengel; K Scott Baker; James G Gurney Journal: Cancer Date: 2008-12-01 Impact factor: 6.860