Bone mineral density in childhood survivors of acute lymphoblastic leukemia treated without cranial irradiation.

2.50
Hdl Handle:
http://hdl.handle.net/10541/76593
Title:
Bone mineral density in childhood survivors of acute lymphoblastic leukemia treated without cranial irradiation.
Authors:
Brennan, Bernadette M; Mughal, Zulf; Roberts, Stephen A; Ward, Kate; Shalet, Stephen M; Eden, Tim O B; Will, Andrew M; Stevens, Richard F; Adams, Judith E
Abstract:
Adult survivors of childhood acute lymphoblastic leukemia (ALL) whose treatment included cranial irradiation (XRT) have reduced bone mineral density (BMD). Fifty-three survivors of ALL (aged 6-17 yr; 22 males and 31 females), who had completed their treatment without XRT, at least 1 yr previously, and 187 (5-19 yr; 86 males and 101 females) healthy controls were examined with dual energy x-ray absorptiometry of the total body and L1-L4 vertebrae and peripheral quantitative computer tomography at the distal and midradial sites. The total body and lumbar spine BMDs did not differ between the ALL survivors and controls. Distal radial trabecular BMD (difference, -0.080 mg/cm(3); 95% confidence interval, -0.139 to -0.020; P = 0.009), but not total BMD (difference, -0.006 mg/cm(3); confidence interval, -0.051 to 0.039; P = 0.80), was lower in ALL survivors compared with controls. At the midradial site, both endosteal (11% larger; P = 0.0001) and periosteal (4% larger; P = 0.001) circumferences were greater, and cortical thickness was thinner by 6% (P = 0.006) in the ALL subjects, leading to an increase in the axial moment of inertia in the ALL subjects (difference, 13%; P = 0.008). In conclusion, BMD, except at the radius, is normal in childhood survivors of ALL treated without XRT. At the midradial site, we speculate that ALL or its treatment resulted in endosteal bone loss and cortical bone thinning, but the axial moment of inertia and, hence, strength was maintained as a result of bone gain at the periosteal surface.
Affiliation:
Department of Hematology and Oncology, Royal Manchester Children's Hospital, Manchester, UK. bernadette.brennan@cmmc.nhs.uk
Citation:
Bone mineral density in childhood survivors of acute lymphoblastic leukemia treated without cranial irradiation. 2005, 90 (2):689-94 J. Clin. Endocrinol. Metab.
Journal:
The Journal of Clinical Endocrinology and Metabolism
Issue Date:
Feb-2005
URI:
http://hdl.handle.net/10541/76593
DOI:
10.1210/jc.2004-1476
PubMed ID:
15562013
Type:
Article
Language:
en
ISSN:
0021-972X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorBrennan, Bernadette M-
dc.contributor.authorMughal, Zulf-
dc.contributor.authorRoberts, Stephen A-
dc.contributor.authorWard, Kate-
dc.contributor.authorShalet, Stephen M-
dc.contributor.authorEden, Tim O B-
dc.contributor.authorWill, Andrew M-
dc.contributor.authorStevens, Richard F-
dc.contributor.authorAdams, Judith E-
dc.date.accessioned2009-08-06T15:09:39Z-
dc.date.available2009-08-06T15:09:39Z-
dc.date.issued2005-02-
dc.identifier.citationBone mineral density in childhood survivors of acute lymphoblastic leukemia treated without cranial irradiation. 2005, 90 (2):689-94 J. Clin. Endocrinol. Metab.en
dc.identifier.issn0021-972X-
dc.identifier.pmid15562013-
dc.identifier.doi10.1210/jc.2004-1476-
dc.identifier.urihttp://hdl.handle.net/10541/76593-
dc.description.abstractAdult survivors of childhood acute lymphoblastic leukemia (ALL) whose treatment included cranial irradiation (XRT) have reduced bone mineral density (BMD). Fifty-three survivors of ALL (aged 6-17 yr; 22 males and 31 females), who had completed their treatment without XRT, at least 1 yr previously, and 187 (5-19 yr; 86 males and 101 females) healthy controls were examined with dual energy x-ray absorptiometry of the total body and L1-L4 vertebrae and peripheral quantitative computer tomography at the distal and midradial sites. The total body and lumbar spine BMDs did not differ between the ALL survivors and controls. Distal radial trabecular BMD (difference, -0.080 mg/cm(3); 95% confidence interval, -0.139 to -0.020; P = 0.009), but not total BMD (difference, -0.006 mg/cm(3); confidence interval, -0.051 to 0.039; P = 0.80), was lower in ALL survivors compared with controls. At the midradial site, both endosteal (11% larger; P = 0.0001) and periosteal (4% larger; P = 0.001) circumferences were greater, and cortical thickness was thinner by 6% (P = 0.006) in the ALL subjects, leading to an increase in the axial moment of inertia in the ALL subjects (difference, 13%; P = 0.008). In conclusion, BMD, except at the radius, is normal in childhood survivors of ALL treated without XRT. At the midradial site, we speculate that ALL or its treatment resulted in endosteal bone loss and cortical bone thinning, but the axial moment of inertia and, hence, strength was maintained as a result of bone gain at the periosteal surface.en
dc.language.isoenen
dc.subjectBrain Canceren
dc.subjectLeukaemiaen
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshBone Density-
dc.subject.meshBrain Neoplasms-
dc.subject.meshChild-
dc.subject.meshChild, Preschool-
dc.subject.meshCranial Irradiation-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshInfant-
dc.subject.meshMale-
dc.subject.meshPrecursor Cell Lymphoblastic Leukemia-Lymphoma-
dc.subject.meshSurvivors-
dc.subject.meshTreatment Outcome-
dc.titleBone mineral density in childhood survivors of acute lymphoblastic leukemia treated without cranial irradiation.en
dc.typeArticleen
dc.contributor.departmentDepartment of Hematology and Oncology, Royal Manchester Children's Hospital, Manchester, UK. bernadette.brennan@cmmc.nhs.uken
dc.identifier.journalThe Journal of Clinical Endocrinology and Metabolismen

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