[Bone mineral density and markers of bone turnover in patients treated for malignant disease in childhood].
Development in diagnostic and therapeutic methods has led to increased survival rates in children with malignancies. The treatment with corticosteroids, methotrexate and irradiation may all cause reduction in bone mass. We assessed bone mineral density (BMD) and several parameters involved in bone formation in long-term survivors with a malignancy at completion of therapy. Total body and lumbar spine bone mineral densities (gram per cm2) were measured by dual energy x-ray absorptiometry in 40 patients (age 12-27 yr; median 17.5 yr; 21 with acute lymphoblastic leukemias, 19 with other malignancies) from 3 to 13.9 years (median 7 yr) after discontinuation of therapy. These results were compared with those from 473 healthy controls and expressed as a percentage of the age and sex-matched control values (mean and standard deviation). Serum levels of osteocalcin, bone specific alkaline phosphatase, parathormone, 1.25 dihydroxyvitamin D, urinary concentrations of deoxypyridinoline were determined as well as several specific markers of bone turnover.


RESULTS
The total BMD and in the lumbar spine were not significantly reduced in survivors of childhood malignancies compared to the control population. No correlation was found between the BMD values and the cumulative doses and time of corticosteroids, administered Mtx, irradiation, duration of treatment, age at diagnosis. Duration of follow-up showed correlation with lumbar spine BMD. Serum markers of bone formation and resorption were in the normal range (expressed as standard deviation score relative to the age and sex-matched healthy population), bone turnover was not disturbed at the time of the study.


CONCLUSIONS
We found no difference in bone mineralisation between our patients and the healthy population.
Muszyńska-Rosłan
Katarzyna
K
Klinika Onkologii Dzieciecej, Akademia Medyczna, ul. Waszyngtona 17, 15-274 Białystok, Poland. KMRoslan@amb.ac.bialystok.pl
Konstantynowicz
Jerzy
J
Krawczuk-Rybak
Maryna
M
Łuczyński
Włodzimierz
W
Kaczmarski
Maciej
M
Wołczynski
Sławomir
S
Piotrowska-Jastrzebska
Janina
J
D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood / Q000187:drug effects; D000970:Antineoplastic Agents / Q000494:pharmacology*; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D001861:Bone Regeneration; D002117:Calcitriol / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D015675:Osteocalcin / Q000097:blood / Q000187:drug effects; D010281:Parathyroid Hormone / Q000378:metabolism; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000378:metabolism; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D015415:Biomarkers; D010281:Parathyroid Hormone; D015675:Osteocalcin; D000469:Alkaline Phosphatase; D002117:Calcitriol