A long-term trajectory of bone mineral density in childhood cancer survivors after discontinuation of treatment: retrospective cohort study

Abstract Background: Patients with urolithiasis have a lower bone mineral density (BMD) than those without stones, suggesting a potential correlation between calcium stone formation and bone resorption disorders, including osteopenia and osteoporosis. Methods: To investigate the influence of BMD on clinical outcomes in urolithiasis, we performed a single-center retrospective cohort study to analyze patients with urolithiasis who underwent both BMD examination and 24-hour urine collection between 2006 and 2015. Data from the national cross-sectional surveillance of the Japanese Society on Urolithiasis Research in 2015 were utilized, and additional data related to urinary tract stones were obtained from medical records. The primary outcome was the development of stone-related symptoms and recurrences during follow-up. A total of 370 patients were included in this 10-year study period. Results: Half of the patients had recurrent stones, and the two-thirds were symptomatic stone formers. While only 9% of patients had hypercalciuria, 27% and 55% had hyperoxaluria and hypocitraturia, respectively. There was a positive correlation between T-scores and urinary citrate excretion. Both univariate and multivariate analyses demonstrated that female sex was associated with recurrences (odds ratio=0.44, p=0.007), whereas a T-score <−2.5 and hyperoxaluria were associated with symptoms (odds ratio=2.59, p=0.037; odds ratio=0.45, p=0.01; respectively). Conclusion: These results revealed that low T-scores might cause symptoms in patients with urolithiasis, suggesting the importance of BMD examination for high-risk Japanese patients with urolithiasis having hypocitraturia.

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Optimizing Detection of Low Bone Mineral Density in Childhood Cancer Survivors

Journal of Clinical Oncology ◽

10.1200/jco.19.01669 ◽

2019 ◽

Vol 37 (25) ◽

pp. 2193-2195

Author(s):

Roderick Skinner

Keyword(s):

Bone Mineral Density ◽

Cancer Survivors ◽

Childhood Cancer ◽

Bone Mineral ◽

Childhood Cancer Survivors ◽

Mineral Density ◽

Low Bone Mineral Density

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Is Recovery of Gonadal function possible in Very Long-Term Adult Male Survivors of Hodgkin's Lymphoma?

Blood ◽

10.1182/blood.v120.21.2065.2065 ◽

2012 ◽

Vol 120 (21) ◽

pp. 2065-2065

Author(s):

Wendy van Dorp ◽

Ivana van der Geest ◽

Joop Laven ◽

Wim C.J. Hop ◽

Sebastian J.C.M.M. Neggers ◽

...

Keyword(s):

Cancer Survivors ◽

Childhood Cancer ◽

Hodgkin Lymphoma ◽

Adult Male ◽

Alkylating Agents ◽

Childhood Cancer Survivors ◽

Inhibin B ◽

Gonadal Function ◽

Discontinuation Of Treatment

Abstract Abstract 2065 Background: Significant improvements in childhood cancer survival rates over recent decades have increased the importance of long-term treatment effects. Gonadal toxicity is a major complication in survivors of childhood cancer, which can especially occur in Hodgkin Lymphoma survivors, since they have been treated with alkylating agents. Inhibin B levels reflect gonadal function in men, and therefore this marker can be used to identify subgroups of childhood cancer survivors at risk for impaired gonadal function. Hitherto in male childhood cancer survivors, follow-up studies of gonadal function are lacking. Objective: To evaluate possible recovery of gonadal dysfunction over time in adult male survivors. Methods: In this retrospective study, adult male long-term childhood cancer survivors (n=201) of whom 24 (12%) were survivors of Hodgkin lymphoma were included. Serum inhibin B levels were used as a surrogate marker for gonadal function. Results: Median age at diagnosis was 6.0 years (range 0.0–17.5) and discontinuation of treatment was reached at a median age of 8.3 years (range 0.0–20.8). Inhibin B levels were first measured after a median follow-up time of 15.7 years (range 3.0–37.0). Median interval between the first (T1) and second measurement (T2) was 3.3 years (range 0.7–11.3). Median inhibin B level was 127 ng/L (range 5–366) at T1 and 156 ng/L (range 10–507) at T2. Survivors with an inhibin B level at first assessment≥105 ng/L have 50% chance to reach normal inhibin B levels, while this probability of recovery is negligible when the first inhibin B level is below 60 ng/L. The latter group consists of survivors of Hodgkin lymphoma treated with alkylating agents and survivors with an AAD score≥3. Conclusions: Our results suggest that recovery of gonadal function is possible even long after discontinuation of treatment. However, this recovery does not seem to occur in survivors who already reached critically low inhibin B levels after discontinuation of treatment, such as in survivors of a Hodgkin lymphoma treated with alkylating agents. Disclosures: No relevant conflicts of interest to declare.

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Bone mineral density deficits in childhood cancer survivors: Pathophysiology, prevalence, screening, and management

Korean Journal of Pediatrics ◽

10.3345/kjp.2013.56.2.60 ◽

2013 ◽

Vol 56 (2) ◽

pp. 60 ◽

Cited By ~ 17

Author(s):

Min Jae Kang ◽

Jung Sub Lim

Keyword(s):

Bone Mineral Density ◽

Cancer Survivors ◽

Childhood Cancer ◽

Bone Mineral ◽

Childhood Cancer Survivors ◽

Mineral Density

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Low bone mineral density is a potential risk factor for symptom onset and related with hypocitraturia in urolithiasis patients: a single-center retrospective cohort study

BMC Urology ◽

10.1186/s12894-020-00749-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Kazumi Taguchi ◽

Shuzo Hamamoto ◽

Atsushi Okada ◽

Yutaro Tanaka ◽

Teruaki Sugino ◽

...

Keyword(s):

Bone Mineral Density ◽

Cohort Study ◽

Bone Mineral ◽

Retrospective Cohort Study ◽

Odds Ratio ◽

Retrospective Cohort ◽

Stone Formation ◽

Single Center ◽

Mineral Density ◽

Stone Formers

Abstract Background Patients with urolithiasis have a lower bone mineral density (BMD) than those without stones, suggesting a potential correlation between calcium stone formation and bone resorption disorders, including osteopenia and osteoporosis. Methods To investigate the influence of BMD on clinical outcomes in urolithiasis, we performed a single-center retrospective cohort study to analyze patients with urolithiasis who underwent both BMD examination and 24-h urine collection between 2006 and 2015. Data from the national cross-sectional surveillance of the Japanese Society on Urolithiasis Research in 2015 were utilized, and additional data related to urinary tract stones were obtained from medical records. The primary outcome was the development of stone-related symptoms and recurrences during follow-up. A total of 370 patients were included in this 10-year study period. Results Half of the patients had recurrent stones, and the two-thirds were symptomatic stone formers. While only 9% of patients had hypercalciuria, 27% and 55% had hyperoxaluria and hypocitraturia, respectively. There was a positive correlation between T-scores and urinary citrate excretion. Both univariate and multivariate analyses demonstrated that female sex was associated with recurrences (odds ratio = 0.44, p = 0.007), whereas a T-score < − 2.5 and hyperoxaluria were associated with symptoms (odds ratio = 2.59, p = 0.037; odds ratio = 0.45, p = 0.01; respectively). Conclusion These results revealed that low T-scores might cause symptoms in patients with urolithiasis, suggesting the importance of BMD examination for high-risk Japanese patients with urolithiasis having hypocitraturia.

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