title: Factors related to decreased bone mineral density in childhood cancer survivors.
abstract: The risk of osteoporosis or osteopenia is known to increase after childhood cancer treatment. The purpose of this study was to evaluate patterns of bone mineral density (BMD) and to identify factors related to the decreased BMD in childhood cancer survivors. We studied 78 patients (34 boys, 44 girls) treated for childhood cancer. Twenty (25.7%) patients had lumbar BMD (LBMD) standard deviation score (SDS) lower than -2. Nineteen (24.4%) patients had femur neck BMD (FNBMD) SDS lower than -2. The patients treated with hematopoietic stem cell transplantation had lower LBMD SDS (-1.17 ± 1.39 vs -0.43 ± 1.33, P = 0.025). The risk of having LBMD SDS < -2 was higher in the patients treated with glucocorticoid (GC) for graft-versus-host disease (GVHD) (36.6% vs 13.5%; odds ratio [OR], 3.7; P = 0.020). In multivariate logistic regression analysis, longer duration of GC treatment for GVHD (OR, 1.12; 95% confidence interval [CI], 1.05-1.20) and lower body mass index (BMI) SDS (OR, 0.59; 95% CI, 0.36-0.95) were associated with decreased LBMD SDS. These findings suggest that prolonged GC use and reduction in BMI are risk factors for decreased BMD in childhood cancer survivors. Anticipatory follow-up and appropriate treatment are necessary, especially for the patients with risk factors.
authors.affiliation: Department of Pediatrics, College of Medicine, the Catholic University of Korea, Seoul, Korea.
authors.forename: Yun Jung
authors.initials: YJ
authors.lastname: Choi
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Park
authors.forename: Won Kyoung
authors.initials: WK
authors.lastname: Cho
authors.forename: Jae Wook
authors.initials: JW
authors.lastname: Lee
authors.forename: Kyoung Soon
authors.initials: KS
authors.lastname: Cho
authors.forename: So Hyun
authors.initials: SH
authors.lastname: Park
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Hahn
authors.forename: Min Ho
authors.initials: MH
authors.lastname: Jung
authors.forename: Nack Gyun
authors.initials: NG
authors.lastname: Chung
authors.forename: Bin
authors.initials: B
authors.lastname: Cho
authors.forename: Byung Kyu
authors.initials: BK
authors.lastname: Suh
authors.forename: Hack Ki
authors.initials: HK
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D015519:Bone Density / Q000187:drug effects*; D001851:Bone Diseases, Metabolic / Q000139:chemically induced*; D002648:Child; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use*; D006086:Graft vs Host Disease / Q000188:drug therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006728:Hormones / Q000097:blood; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000473:pathology; D015470:Leukemia, Myeloid, Acute / Q000473:pathology; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000473:pathology; D012307:Risk Factors; D017741:Survivors
chemical_list: D005938:Glucocorticoids; D006728:Hormones
keywords: Bone Density; Glucocorticoids; Neoplasms