F R, KH A, F Z, S S. Evaluation of bone mineral density in long-term survivors of childhood acute lymphoblastic leukemia. Iranian Journal of Blood and Cancer 2013; 5 (4) :137-143
URL:
http://ijbc.ir/article-1-417-en.html
Abstract: (9784 Views)
Background: The purpose of this study was to evaluate long-term changes in bone density profile among survivors
of childhood acute lymphoblastic leukemia.
Patients and Methods: This was a 5 year prospective study comprised of thirty-one survivors of childhood acute
lymphoblastic leukemia with a mean age of 11.8 (4.6) years, who completed therapy at least 1 year previously
(according to the ALL-6 therapeutic protocol), and remained in complete continuous remission. BMD was measured
from the lumbar spines (L2 to L4) and femoral neck, at baseline (2006) and after 5 years (2011), using dual energy
x-ray absorbtiometry. Bone mineral density Z score and bone mineral content were calculated for both lumbar spine
and femoral neck.
Results: The mean femoral bone mineral density was 0.69 in 2006 and 0.82 in 2011 (p=0.005). The mean femoral Z
score was -1.38 in 2006 and -0.55 in 2011 (p=0.006). For the lumbar spine, the mean bone mineral density was 0.71
in 2006 and 0.88 in 2011 (p=0.000) and the mean Z score was -2.08 in 2006 and -0.93 in 2011 (p=0.000) respectively.
All three indices significantly changed through-out the study period. The general linear regression analysis revealed
that daily calcium intake was an important predictor of lumbar spine BMD Z score. Femoral neck BMD Z score was
correlated with the serum vitamin D level.
Conclusion: Osteopenia in survivors of childhood acute lymphoblastic leukemia constitutes an important health
risk. Patients and their families should be encouraged to take sufficient amount of calcium and vitamin D during
chemotherapy and afterward.
Keywords: Acute lymphoblastic leukemia, bone mineral density, bone mineral content, dual energy x-ray
absorbtiometry (DXA), Iran.
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Original Article |
Subject:
Pediatric Hematology & Oncology Received: 2013/02/12 | Accepted: 2013/05/11 | Published: 2013/10/7