title: Pediatric Hodgkin lymphoma survivors at negligible risk for significant bone mineral density deficits.
abstract: BACKGROUND
  We hypothesized that pediatric Hodgkin lymphoma (HL) survivors would have bone mineral density (BMD) deficits compared to their peers because of osteotoxic chemotherapy during the time of greatest BMD accretion.
  
  
  METHODS
  We retrospectively reviewed records of HL survivors returning for follow-up between 1990 and 2002. Of the 133 eligible survivors, 109 who underwent quantitative computed tomography (QCT) comprised the study group. QCT-determined BMD Z-scores were correlated with patient characteristics and therapeutic exposures by Wilcoxon rank sum or Chi-square tests. Logistic regression models were used to explore risk factors for diminished BMD.
  
  
  RESULTS
  The study cohort was half male (50.5%) and 85.3% reported their race as white. Participants were representative of all survivors potentially eligible for study, except that more study participants were female, had hypothyroidism, and had received cyclophosphamide. Median age at diagnosis was 15.1 years (range, 3.1-20.7 years); median time between diagnosis and QCT was 7.5 years (range, 5.0-12.4 years). The proportion of HL survivors with BMD below the mean did not significantly differ from the general population (P = 0.503). However, those with BMD -1.5 SD and BMD -2.0 SD or lower (14.7% and 7.3%, respectively) exceeded that in the general population (6.7% and 2.3%, respectively; P < 0.001 for both degrees of severity). Males, diagnosed at 14 years or older, were at 6.5 times higher risk than females (OR 95% CI: 1.24-34.14; P = 0.027) for BMD deficits.
  
  
  CONCLUSIONS
  Overall, pediatric HL survivors had negligible BMD deficits. Male gender was associated with an increased risk of developing BMD deficits.
authors.affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-2794, USA. sue.kaste@stjude.org
authors.forename: Sue C
authors.initials: SC
authors.lastname: Kaste
authors.forename: Monika L
authors.initials: ML
authors.lastname: Metzger
authors.forename: Anum
authors.initials: A
authors.lastname: Minhas
authors.forename: Zang
authors.initials: Z
authors.lastname: Xiong
authors.forename: Shesh N
authors.initials: SN
authors.lastname: Rai
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D017741:Survivors; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents