Bone mineral density surveillance for childhood, adolescent, and young adult cancer survivors: recommendations from the international late effects of childhood cancer guideline harmonization group (IGHG)
Van Atteveld, J. Mulder, R. Van Den Heuvel-Eibrink, M. Hudson, M. Kremer, L. Skinner, R. Wallace, H. Constine, L. Kaste, S.
Van Atteveld, J.
Mulder, R.
Van Den Heuvel-Eibrink, M.
Hudson, M.
Kremer, L.
Skinner, R.
Wallace, H.
Constine, L.
Kaste, S.
Citations
Altmetric:
Abstract
Background and Aims:Childhood,adolescentandyoungadult(CAYA)cancersurvivorsareatincreasedriskof(very)lowbonemineralden-sity(BMD).Clinicalpracticesurveillanceguidelinesareimportantfortimelydiagnosisandtreatmentofthesesurvivors,whichcouldimproveBMDparametersandpreventfragilityfractures.Discordancesacrosscurrentlate-effectsguidelinesnecessitatedinternationalharmoniza-tionofBMDsurveillancerecommendations.Methods:TheIGHGestablishedapanelof36expertsfrom10coun-tries,representingarangeofrelevantmedicalspecialties.Theevidenceofriskfactorsforlow(Z-score≤-1)andverylow(Z-score≤-2)BMDandfractures,surveillancemodality,timingofBMDsurveillance,andtreatmentof(very)lowBMDwereevaluatedandcriticallyappraised,and harmonized recommendations for CAYA cancer survivors wereformulated.Wegradedtherecommendationsbasedonthequalityofunderlyingevidenceandthebalancebetweenpotentialbenefitsandharms.Results:BMDsurveillanceisrecommendedforsurvivorstreatedwithcranial or craniospinal radiotherapy, and is reasonable for survivorstreated with total body irradiation. Due to insufficient evidence, norecommendationcanbeformulatedfororagainstBMDsurveillancefor survivors treated with corticosteroids. This surveillance decisionshouldbemadebythesurvivorandhealthcareprovidertogether,aftercareful consideration of the potential harms and benefits and addi-tionalriskfactors.WerecommendtoperformBMDsurveillanceusingdual-energy X-ray absorptiometry at entry into long-term follow-up(between2-5yearsfollowingtreatmentcessation),andifnormal(Z-score>-1), repeat at 25 years of age when peak bone mass shouldbeachieved.Betweenthesetwomeasurementsandthereafter,BMDsurveillanceshouldbeperformedasclinicallyindicatedbasedonBMDandongoingriskassessment.Conclusions:ThisguidelineprovidesBMDsurveillancerecommenda-tionsthatmayimprovehealthoutcomesbyfacilitatingmoreconsistentcareforCAYAcancersurvivorsinternationally.Inaddition,itpromotesstrategicallyplannedongoingresearchthatwillinformfutureguideline updates.
Authors
Van Atteveld, J.
Mulder, R.
Van Den Heuvel-Eibrink, M.
Hudson, M.
Kremer, L.
Skinner, R.
Wallace, H.
Constine, L.
Higham, Claire E
Kaste, S.
Niinimaki, R.
Mostoufi-Moab, S.
Alos, N.
Fintini, D.
Templeton, K.
Ward, L.
Frey, E.
Franceschi, R.
Pavasovic, V.
Karol, S.
Amin, N.
Vrooman, L.
Harila-Saari, A.
Demoor-Goldschmidt, C.
Murray, R.
Bardi, E.
Lequin, M.
Faienza, M. F.
Zaikova, O.
Berger, C.
Mora, S.
Ness, K.
Neggers, S.
Pluijm, S.
Simmons, J.
Di Iorgi, N.
Mulder, R.
Van Den Heuvel-Eibrink, M.
Hudson, M.
Kremer, L.
Skinner, R.
Wallace, H.
Constine, L.
Higham, Claire E
Kaste, S.
Niinimaki, R.
Mostoufi-Moab, S.
Alos, N.
Fintini, D.
Templeton, K.
Ward, L.
Frey, E.
Franceschi, R.
Pavasovic, V.
Karol, S.
Amin, N.
Vrooman, L.
Harila-Saari, A.
Demoor-Goldschmidt, C.
Murray, R.
Bardi, E.
Lequin, M.
Faienza, M. F.
Zaikova, O.
Berger, C.
Mora, S.
Ness, K.
Neggers, S.
Pluijm, S.
Simmons, J.
Di Iorgi, N.
Description
Date
2021
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Van Atteveld J, Mulder R, Van Den Heuvel-Eibrink M, Hudson M, Kremer L, Skinner R, et al. Bone Mineral Density Surveillance for Childhood, Adolescent, and Young Adult Cancer Survivors: Recommendations from The International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG). Pediatric Blood & Cancer. 2021;68:S120-S1.