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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.
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
html.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.


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