Bone mineral density in pediatric survivors of Hodgkin and non-Hodgkin lymphomas

Adv Med Sci. 2014 Sep;59(2):200-5. doi: 10.1016/j.advms.2014.02.004. Epub 2014 Jun 9.

Abstract

Purpose: To assess skeletal mass in survivors of childhood Hodgkin disease (HD) and non-Hodgkin lymphoma (NHL) 1-5 years after treatment, and to identify potential risk factors influencing bone mineral density (BMD).

Patients/methods: This cross-sectional study was conducted in a cohort of 43 survivors (HD=31; NHL=12); mean age: 16.21 ± 4.4. Total body bone mineral content (TBMC) and density (TBBMD), and lumbar spine density (LSBMD) were determined using dual-energy X-ray absorptiometry.

Results: Three of all 43 patients developed low BMD. No significant differences in height, weight, and/or BMD Z-scores were found between HD and NHL survivors, children who received and did not receive radiotherapy, and the groups with different chemotherapeutic blocks. No differences were noted between the Z-scores of BMC (mean ± SD: 0.31 ± 1.29 vs. -0.089 ± 0.61, p=0.165), TBBMD (mean ± SD: -0.32 ± 1.21 vs. -0.27 ± 0.91, p=0.76), or the LSBMD (mean ± SD: -0.183 ± 1.54 vs. -0.17 ± 0.87, p=0.637) in subgroups, in accordance with time after therapy (subgroup I<2 years and subgroup II>2 years after treatment). In HD survivors, age at diagnosis only affected the TBBMD Z-score (a decrease of 0.127 in total BMD Z-score per each year, R²=0.999, p<0.001).

Conclusions: Childhood lymphoma survivors demonstrate no significant deficits in bone mass and tend to maintain their BMD within the normal range when presenting during one to five years' follow-up. However, this specific group requires longitudinal investigation to assess the pattern of peak bone mass achievement and the risk of future bone loss.

Keywords: Bone mineral density; Children; Hodgkin lymphoma; Non-Hodgkin lymphoma; Survivors.

MeSH terms

  • Adolescent
  • Adult
  • Bone Density*
  • Bone Resorption / complications*
  • Bone Resorption / epidemiology
  • Child
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Hodgkin Disease / complications*
  • Hodgkin Disease / therapy
  • Humans
  • Lymphoma, Non-Hodgkin / complications*
  • Lymphoma, Non-Hodgkin / therapy
  • Male
  • Poland / epidemiology
  • Risk Factors
  • Survivors*
  • Young Adult