Bone density in survivors of childhood malignancies.
OBJECTIVE
The purpose of this study was to assess bone mineralization in survivors of childhood malignancies.


METHODS
Bone mineral density (BMD) of the lumbar spine was measured in 60 patients aged 5.5-20.1 years (mean, 12.4 years) who had no known disease 1.0-14.5 years (mean, 4.3 years) after completing treatment for a malignancy. The age-normalized BMD findings (Z scores) were correlated with multiple variables, including measures of growth and nutrition, type of malignancy, and various treatments, including use of steroids, methotrexate, or cranial irradiation.


RESULTS
BMD was normal in most patients with a mean Z score of -0.28 + 0.14 (+/- SE). Only 8% of the patients were more than 2 SDs below age-matched normal BMD. Weight Z score was the major determinant of BMD Z score. Calcium intake and height Z score were also important variables.


CONCLUSIONS
Most survivors of childhood malignancies will not be left with a clinically significant deficit in BMD. Risk factors for diminished BMD include low-weight and low-height Z scores and low calcium intake. Therapeutic interventions are available to address these risk factors in those patients with significantly diminished BMD.
Department of Orthopaedics, University of North Carolina, Chapel Hill 27599-7055, USA.
R C
RC
Henderson
C D
CD
Madsen
C
C
Davis
S H
SH
Gold
D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001835:Body Weight; D015519:Bone Density; D002118:Calcium / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D006257:Head / Q000528:radiation effects; D006801:Humans; D007223:Infant; D009369:Neoplasms / Q000628:therapy
D000970:Antineoplastic Agents; D002118:Calcium