Long-term effects on bone mineral density of different therapeutic schemes for acute lymphoblastic leukemia or non-Hodgkin lymphoma during childhood.
BACKGROUND
Little is known regarding long-term bone deficit in relationship with the modalities of cancer therapy among survivors of childhood malignancy.


METHODS
Bone mineral density (BMD) was evaluated at lumbar spine (LS), total hip and femoral neck in 89 patients (44 men) more than 5 years after remission of childhood acute lymphoblastic leukemia (ALL) or non-Hodgkin lymphoma (NHL). The patients had received chemotherapy (group I; n = 41), chemotherapy and cranial irradiation (group II; n = 32), or bone marrow transplantation (BMT) with total body irradiation (TBI) (group III; n = 16). All patients had received methylprednisolone and 47 additional dexamethasone treatment.


RESULTS
A reduced BMD at any site was observed in 44 of the 89 patients, more frequently in men (66%) than women (33%) (p < 0.001). In comparison with group I, mean BMD was significantly lower at all sites in group II and at the total hip and femoral neck in group III. A multivariate analysis showed independent significant influences of male gender at LS (p < 0.001) and of type of treatment and dexamethasone at the hip (p < 0.05).


CONCLUSIONS
A low bone mass is frequently observed in adult survivors of childhood ALL and NHL, and is associated with male gender at the LS and with dexamethasone treatment, cranial irradiation and BMT/TBI at the hip.
Benmiloud
Sarra
S
Steffens
Mélanie
M
Beauloye
Véronique
V
de Wandeleer
Ann
A
Devogelaer
Jean-Pierre
JP
Brichard
Bénédicte
B
Vermylen
Christiane
C
Maiter
Dominique
D
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001827:Body Height / Q000187:drug effects / Q000528:radiation effects; D015519:Bone Density / Q000187:drug effects* / Q000528:radiation effects*; D016026:Bone Marrow Transplantation; D002648:Child; D003131:Combined Modality Therapy / Q000009:adverse effects; D016371:Cranial Irradiation / Q000009:adverse effects; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005272:Femur Neck / Q000737:chemistry; D005500:Follow-Up Studies; D006615:Hip / Q000528:radiation effects; D006801:Humans; D008159:Lumbar Vertebrae / Q000737:chemistry; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D012727:Sex Characteristics; D014916:Whole-Body Irradiation / Q000009:adverse effects
D000970:Antineoplastic Agents; D003907:Dexamethasone; D008775:Methylprednisolone