title: Bone mineral density is close to normal for age in long-term lymphoma survivors treated with high-dose therapy with autologous stem cell transplantation.
abstract: BACKGROUND
  Few studies have assessed bone health in lymphoma survivors treated with high-dose therapy with autologous stem cell transplantation (HDT-ASCT). Therefore, we aimed to assess bone mineral density (BMD) at six different skeletal sites and to investigate associations between clinical factors and BMD in these survivors.
  
  
  METHODS
  Eligible lymphoma survivors were aged ≥18 years at diagnosis and at HDT-ASCT given between 1987 and 2008. Participants responded to questionnaires, blood samples were drawn, and a dual energy X-ray absorptiometry (DXA) was performed. Mean Z-score was applied for assessment of BMD in relation to age. Prevalence of Z-scores ≥-1, between -1 and -2, and ≤-2 is reported for each measurement site and for the lumbar spine, femoral neck, and hip in combination. Likewise, T-scores were applied to assess the prevalence of normal BMD (≥-1), osteopenia (between -1 and -2.5), and osteoporosis (≤-2.5).
  
  
  RESULTS
  We included 228 lymphoma survivors, of whom 62% were males. The median age at survey was 56 years, and median observation time from HDT-ASCT was eight years. Among males, Z-scores were lower at the left femoral neck and higher at the ultra-distal (UD) radius and whole body compared to the Lunar reference database. In females, Z-scores were lower at UD radius and one-third (33%) radius and higher at the whole body. Using a classification based on Z-scores at the lumbar spine, femoral neck, and hip in combination, 25% of males and 16% of females had Z-scores <-1 and >-2, while 8% and 6% had Z-scores ≤-2. According to T-scores, 35% of males and 41% of females had osteopenia, while 8% and 13% had osteoporosis, respectively.
  
  
  CONCLUSIONS
  BMD was close to normal for age in this population of long-term lymphoma survivors treated with HDT-ASCT.
authors.affiliation: a National Advisory Unit on Late Effects After Cancer Treatment, Department of Oncology , Oslo University Hospital , Oslo , Norway.
authors.forename: Mette
authors.initials: M
authors.lastname: Seland
authors.affiliation: a National Advisory Unit on Late Effects After Cancer Treatment, Department of Oncology , Oslo University Hospital , Oslo , Norway.
authors.forename: Knut B
authors.initials: KB
authors.lastname: Smeland
authors.affiliation: b Department of Medical Biochemistry , Oslo University Hospital , Oslo , Norway.|c Institute of Clinical Medicine, Faculty of Medicine , University of Oslo , Oslo , Norway.
authors.forename: Trine
authors.initials: T
authors.lastname: Bjøro
authors.affiliation: d Oslo Centre for Biostatistics and Epidemiology, Research Support Services , Oslo University Hospital , Oslo , Norway.
authors.forename: Ragnhild S
authors.initials: RS
authors.lastname: Falk
authors.affiliation: a National Advisory Unit on Late Effects After Cancer Treatment, Department of Oncology , Oslo University Hospital , Oslo , Norway.
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fosså
authors.affiliation: e Department of Rheumatology , Haukeland University Hospital , Bergen , Norway.|f Department of Clinical Science , University of Bergen , Bergen , Norway.
authors.forename: Clara G
authors.initials: CG
authors.lastname: Gjesdal
authors.affiliation: g Section of Specialized Endocrinology, Department of Endocrinology , Oslo University Hospital Rikshospitalet , Oslo , Norway.
authors.forename: Kristin
authors.initials: K
authors.lastname: Godang
authors.affiliation: h Department of Oncology , Oslo University Hospital , Oslo , Norway.
authors.forename: Harald
authors.initials: H
authors.lastname: Holte
authors.affiliation: i Division of Internal Medicine , University Hospital of North Norway , Tromsø , Norway.|j Tromsø Endocrine Research Group, Institute of Clinical Medicine , UiT The Arctic University of Norway , Tromsø , Norway.
authors.forename: Johan
authors.initials: J
authors.lastname: Svartberg
authors.affiliation: k Department of Endocrinology , St. Olav's Hospital , Trondheim , Norway.|l Department of Cancer Research and Molecular Medicine , Norwegian University of Science and Technology , Trondheim , Norway.
authors.forename: Unni
authors.initials: U
authors.lastname: Syversen
authors.affiliation: c Institute of Clinical Medicine, Faculty of Medicine , University of Oslo , Oslo , Norway.|g Section of Specialized Endocrinology, Department of Endocrinology , Oslo University Hospital Rikshospitalet , Oslo , Norway.
authors.forename: Jens
authors.initials: J
authors.lastname: Bollerslev
authors.affiliation: a National Advisory Unit on Late Effects After Cancer Treatment, Department of Oncology , Oslo University Hospital , Oslo , Norway.
authors.forename: Cecilie E
authors.initials: CE
authors.lastname: Kiserud
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology*; D015995:Prevalence; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D017741:Survivors; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents