title: Alterations in bone mineral density and bone turnover markers in newly diagnosed adults with lymphoma receiving chemotherapy: a 1-year prospective pilot study.
abstract: BACKGROUND
  Bone mineral density (BMD) loss is poorly defined in lymphoma patients. The aim of this study was to measure the extent of BMD loss in newly diagnosed lymphoma patients receiving chemotherapy.
  
  
  METHODS
  This was a prospective, single-center study conducted in patients aged≥18 years with previously confirmed lymphoma treated by chemotherapy. Patients with low baseline BMD defined as Z/T-score less than or equal to -2.5 and/or history of osteoporotic fractures were excluded. BMD was measured at baseline before initiating chemotherapy and 1 year later. Predictive factors of BMD loss were investigated.
  
  
  RESULTS
  Forty-one lymphoma patients (31 males and 10 females) receiving chemotherapy were enrolled. The median age at diagnosis was 59 (range: 19-86) years. Histological subtypes were predominantly diffuse large B-cell lymphoma (58%), mostly stage III-IV (54%). All patients received chemotherapy and 22% of patients received second-line treatment due to relapse or progressive disease. Thirty-two patients were evaluable at 1 year. The mean BMD changes were: -2.7%±3.9% for lumbar spine (P<0.001), -2.2%±7.6% for femoral neck (P<0.01) and -2.6%±4.5% for total hip (P<0.0001). In multivariate analysis, predictive factors of BMD loss at baseline were (i) at lumbar spine: female gender (P=0.01), higher lactate dehydrogenase level (P=0.04) and lower creatinine clearance (P=0.01); (ii) at total hip: lower albumin (P=0.01), higher corrected serum calcium (P<0.01), lower alkaline phosphatase (AP) (P<0.01) and autologous stem cell transplant (P=0.03); and (iii) at femoral neck: higher corrected serum calcium (P=0.02) and lower bone AP (P=0.01).
  
  
  CONCLUSIONS
  Adult patients with known lymphoma receiving chemotherapy experienced significant BMD loss at 1 year.
authors.affiliation: Department of Rheumatology.
authors.forename: J
authors.initials: J
authors.lastname: Paccou
authors.forename: L
authors.initials: L
authors.lastname: Merlusca
authors.forename: I
authors.initials: I
authors.lastname: Henry-Desailly
authors.forename: A
authors.initials: A
authors.lastname: Parcelier
authors.forename: B
authors.initials: B
authors.lastname: Gruson
authors.forename: B
authors.initials: B
authors.lastname: Royer
authors.forename: A
authors.initials: A
authors.lastname: Charbonnier
authors.forename: D
authors.initials: D
authors.lastname: Ursu
authors.forename: R
authors.initials: R
authors.lastname: Desailloud
authors.forename: R
authors.initials: R
authors.lastname: Garidi
authors.forename: S
authors.initials: S
authors.lastname: Kamel
authors.forename: H
authors.initials: H
authors.lastname: Sevestre
authors.forename: J P
authors.initials: JP
authors.lastname: Marolleau
authors.forename: P
authors.initials: P
authors.lastname: Fardellone
authors.forename: G
authors.initials: G
authors.lastname: Damaj
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D001862:Bone Resorption / Q000097:blood* / Q000473:pathology; D005260:Female; D005272:Femur Neck / Q000473:pathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D008223:Lymphoma / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers
keywords: bone mineral density; bone turnover markers; chemotherapy; corticosteroids; lymphoma