scholarly journals Association of bone mineral density with incidental renal stone in long-term survivors of childhood acute lymphoblastic leukemia.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9527-9527
Author(s):  
Prasad Laxman Gawade ◽  
Kirsten K. Ness ◽  
Shelly Sharma ◽  
Zhenghong Li ◽  
Deo Kumar Srivastava ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Acute Lymphoblastic Leukemia ◽  
Renal Dysfunction ◽  
Renal Stone ◽  
Lymphoblastic Leukemia ◽  
Renal Stones ◽  
Z Score ◽  
Mineral Density

9527 Background: With 5-year survival of childhood acute lymphoblastic leukemia (ALL) now exceeding 90%, long term morbidities are of growing concern. Both low bone mineral density (BMD) and renal dysfunction have been reported in ALL survivors. Our objective was to evaluate the association between low BMD and incidental renal stones, a known predictor of renal dysfunction. Methods: Adult participants who were 10+ year survivors of childhood ALL and members of St. Jude Lifetime Cohort study were recruited between 12/2007 and 3/2011. During their risk-based medical evaluations they underwent quantitative computed tomography (QCT) to evaluate BMD. Incidental renal stones were identified by radiologists’ review of axial QCT source images. Demographic information was abstracted from responses to health surveys and dietary intake from a Block food frequency questionnaire. Association between BMD and renal stones was evaluated in a multivariable logistic regression model. Confounding variables were selected using directed acyclic graphs and change in effect estimates strategy. Results: At a median of 26.1 years from diagnosis, BMD Z score of > 1 standard deviation (SD) was detected in 77/662 (11.6%) and renal stones in 73/662 (11%) participants. In a multivariable model adjusted for age, dietary vitamin D and renal radiation, when compared to BMD Z score > 1 SD, the risk of renal stones increased with a decrease in BMD Z-score; 1 to 0 SD (Odds Ratio (OR), 1.93; 95% confidence interval (CI), 0.69 to 5.41), 0 to -1 SD (OR, 1.46; 95% CI, 0.52 to 4.05), -1 to -2 SD (OR, 2.72; 95% CI, 0.81 to 6.41), and ≤ -2 SD (OR, 4.96; 95% CI, 1.43 to 17.13). Older age (45-54 vs.18-24 y; OR, 3.66; 95% CI, 1.10 to 12.15), renal radiation (OR, 1.97; 95% CI, 0.59 to 6.50) and > 141.5 IU intake of vitamin D (OR, 1.65; 95% CI, 0.98 to 2.77) were also associated with renal stone formation. Conclusions: Our results not only help us recognize survivors at risk, but also informs radiologists to be vigilant of incidental renal stones among older ALL survivors with low BMD.

scholarly journals P1621VITAMIN D SUPPLEMENTATION: CHANGES IN BONE MINERAL DENSITY IN KIDNEY TRANSPLANT PATIENTS WITH LONG TERM DURATION OF THE GRAFT

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Yuri Battaglia ◽  
Michele Provenzano ◽  
Francesco Tondolo ◽  
Antonio Bellasi ◽  
Pasquale Esposito ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Kidney Transplant ◽  
Bone Mineral ◽  
Categorical Variables ◽  
Z Score ◽  
Mineral Density ◽  
T Score

Abstract Background and Aims In the medical literature, several studies have linked bone mineral density (BMD) with vitamin D deficiency in kidney transplant patients (KTRs). However, in spite of the fact that ergocalciferol, cholecalciferol and calcifediol reduce parathyroid hormone (PTH) and improves calcium levels, their effects on the bone mineral density (BMD) in KTRs remain undefined. In consideration of the lack of data available, we aim at investigating the effect of inactive form of vitamin D supplementation on the BMD over a follow-up period up to 2 year, in a real-life cohort of long-term kidney transplant(KT). Method This study was carried out in KTRs who were followed up in a Nephrology Unit. Exclusion criteria were parathyroidectomy, therapy with bisphosphonate, previous history of bone fractures. Demographic, clinical and immunosuppressive agents were collected. Based on 25-OH-D levels, KTRs were classified as suffering from deficiency (< 30 ng/mL). BMD was evaluated at lumbar vertebral bodies (LV) and right femoral hip (FH) by a single operator, using a standard dual energy X-ray absorptiometry. According to WHO criteria, results were expressed as T-score (standard deviation [SD] relative to young healthy adults), and Z-score (SD relative to age-matched controls). Osteoporosis and osteopenia were defined as T score ≤ −2.5 SD and T score < −1 and > −2.5 SD, respectively. Laboratory data, 25-OH-D, and BMD were measured at baseline and after 24 months of supplementation therapy. Vitamin D deficiency was corrected using standard treatment strategy recommended for general population. Continuous variables were expressed as mean ± SD whereas categorical variables as percentage. The Student’s t test and chi-square test were used to compare to compare continuous and categorical variables, respectively. For before and after comparisons of continuous variables, the paired t-test or one-sample Wilcoxon signed rank test were used based on variable’s distribution. Results Data pertaining to 111 out of 133 consecutive outpatients were collected, of whom most were males (69.4%), no-smokers (89.1%) and treated with glucocorticoids (84%). The mean age was 53.9±11.6 years and months after transplant was 161.6±128.3. No statistical differences were found among patients with normal BMD, osteopenia or osteoporosis at LV and FH in terms of age at transplant, gender distribution, time on dialysis, BMI and eGFR, serum calcium, serum phosphate, 25-OH-D and iPTH. At baseline, 25-OH-D was 13.9±7.2 ng/ml and the prevalence of osteopenia/osteoporosis was 40.9% (T-Score -1.69±0.37; Z-score -1.16±1.09) and 21.8 % (T-Score -3.15±0.50; Z-score -2.27±0.58) at LV; 55.3 % (T-Score -1.8±0.46; Z-score -0.84±0.633) and 14 % (T-Score -2.83±0.39; Z-score -1.65±0.49) at FH. After 27.6±3.7 months of therapy with cholecalciferol at mean dose of 13.396±7.537 UI at week, 25-OH-D values increased to 29.4±9.4 ng/ml (p<0.0001) while no statistically significant changes were found in Z-score and T-score at both sites, except for a mild improvement in lumbar vertebral Z-score, reaching −0.82± 0.7 (p = 0.06) in KTRs with osteopenia Conclusion Our study showed BMD remained stable after up to 2 years of inactive vitamin D therapy in long-term kidney transplant with vitamin D deficiency. A mild increase in Z-score was observed in the L-spine. Further designated studies should be conducted to demonstrate the effect of vitamin D on BMD.

Long-Term Effects on Bone Mineral Density of Different Therapeutic Schemes for Acute Lymphoblastic Leukemia or Non-Hodgkin Lymphoma during Childhood

2010 ◽  
Vol 74 (4) ◽  
pp. 241-250 ◽  
Author(s):  
Sarra Benmiloud ◽  
Mélanie Steffens ◽  
Véronique Beauloye ◽  
Ann de Wandeleer ◽  
Jean-Pierre Devogelaer ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Acute Lymphoblastic Leukemia ◽  
Hodgkin Lymphoma ◽  
Bone Mineral ◽  
Lymphoblastic Leukemia ◽  
Long Term Effects ◽  
Mineral Density ◽  
Non Hodgkin Lymphoma

Bone mineral density, body composition, and height in long-term survivors of acute lymphoblastic leukemia in childhood

2000 ◽  
Vol 35 (4) ◽  
pp. 415-420 ◽  
Author(s):  
Inge M. van der Sluis ◽  
Marry M. van den Heuvel-Eibrink ◽  
Karel H�hlen ◽  
Eric P. Krenning ◽  
Sabine M.P.F. de Muinck Keizer-Schrama
Keyword(s):  
Bone Mineral Density ◽  
Body Composition ◽  
Acute Lymphoblastic Leukemia ◽  
Bone Mineral ◽  
Lymphoblastic Leukemia ◽  
Mineral Density ◽  
Long Term Survivors

scholarly journals Az akut lymphoblastos leukaemiával kezelt gyermekek csontrendszerét érintő mellékhatások

2020 ◽  
Vol 161 (49) ◽  
pp. 2086-2093
Author(s):  
Nikolett Jusztina Beniczky ◽  
Éva Hosszú ◽  
Dániel János Erdélyi ◽  
Judit Müller ◽  
Zsuzsanna Jakab ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Acute Lymphoblastic Leukemia ◽  
Side Effects ◽  
Maintenance Therapy ◽  
Lymphoblastic Leukemia ◽  
Z Score ◽  
Mineral Density ◽  
Cholesterol Levels

Összefoglaló. Bevezetés: A gyermekkori akut lymphoblastos leukaemia kezelése napjainkban 80% feletti túlélést tesz lehetővé, de fontos cél a kezelés okozta mellékhatások kivédése és a gyermekek hosszú távú életminőségének javítása is. Célkitűzés: A kemoterápia csontrendszerre kifejtett mellékhatásainak vizsgálata és a prognosztikai tényezők feltárása, a rizikófaktorok összegyűjtése. Módszerek: Retrospektív vizsgálatunkba a Semmelweis Egyetem II. Gyermekgyógyászati Klinikáján 2007 és 2016 között kezelt 215, akut lymphoblastos leukaemiás gyermek közül a csontelváltozást észlelt betegeket vontuk be a következő, csontrendszert érintő megbetegedésekkel: 38 gyermeknél csökkent csontásványianyag-tartalom, 5 főnél osteonecrosis, 3 főnél osteomyelitis és 2 fő esetében patológiás fractura volt detektálható. Különböző követési időpontokban gyűjtöttünk oszteodenzitometriai adatokat, D-vitamin-, foszfát-, alkalikusfoszfatáz- és lipidszinteket is. Eredmények: Az oszteodenzitometriai értékek már a diagnóziskor csökkent értéket mutatnak, az intenzív vénás kemoterápia hatására pedig további csökkenés figyelhető meg (a lumbális gerinc Z-score-értéke a kezelés kezdetén: –1,5 ± 1,02, az intenzív vénás kezelés végén –1,8 ± 0,5). A Z-score-értékek a fenntartó terápia végére javuló tendenciát mutattak (–1,6 ± 0,5; p<0,05), majd az utánkövetés során ismételt javulás (–1,2 ± 0,4 [p<0,01] és –0,9 ± 0,4) figyelhető meg. A D-vitamin-szintek esetében az intenzív vénás kemoterápiát követően fokozatos javulást láthattunk (20 ± 3,1 ng/ml vs. többéves utánkövetéskor 31 ± 2,6 ng/ml; p<0,001). A foszfát- és alkalikusfoszfatáz-szintek nem változtak számottevő mértékben a vizsgált időtartam során. A koleszterinszintek a terápia során folyamatos növekedést mutattak (a kemoterápia kezdetén 3,28 ± 0,3 mM/l vs. a fenntartó kezelés végén 4,62 ± 0,2 mM/l; p<0,0001). A HDL-koleszterin esetében szintén hasonló tendenciát figyelhettünk meg (a diagnóziskor 0,53 ± 0,09 mM/l vs. a fenntartó kezelés végén 1,48 ± 0,14 mM/l). Következtetés: Kiemelendő, hogy a gyógyult gyermekek utánkövetése, az oszteodenzitometriai mérések és a laborparaméterek ellenőrzése rendkívül fontos, mivel csontelváltozásokkal a leukaemiás betegek esetén számolni kell. Orv Hetil. 2020; 161(49): 2086–2093. Summary. Introduction: Current treatment of pediatric acute lymphoblastic leukemia allows survival above 80%, but it is also very important to prevent treatment-related side effects and to improve long-term quality of life. Objective: Our aim was to assess the side effects of chemotherapy on the skeletal system and to identify prognostic and risk factors. Methods: Between 2007 and 2016, 215 children were treated with acute lymphoblastic leukemia at the 2nd Department of Paediatrics, Semmelweis University. In our retrospective study, we analyzed data of these children with skeletal-related side-effects (38 children with reduced bone mineral density, 5 with osteonecrosis, 3 with osteomyelitis and 2 with pathologic fracture). Results: Osteodensitometric data, vitamin D, phosphate, alkaline phosphatase and lipid levels were collected at different follow-up times. Osteodensitometric values were already reduced at the time of diagnosis (lumbar spine Z-score: –1.5 ± 1.02) and intensive venous chemotherapy caused further decrease (–1.8 ± 0.5). Z-score showed an improving tendency at the end of the maintenance therapy (–1.6 ± 0.5; p<0.05), followed by further improvement later (–1.2 ± 0.4 [p<0.01] and –0.9 ± 0.4). Vitamin D levels showed improvement after intensive venous chemotherapy (20 ± 3.1 ng/ml vs. 31 ± 2.6 ng/ml at multi-year follow-up; p<001). Phosphate and alkaline phosphatase levels did not change considerably during the period considered. Cholesterol levels increased continuously during treatment (at the time of diagnosis 3.28 ± 0.3 mM/l vs. at the end of the maintenance therapy 4.62 ± 0.2 mM/l; p<0.0001). A similar trend was observed with HDL cholesterol levels (0.53 ± 0.09 mM/l vs. 1.48 ± 0.14 mM/l). Conclusion: In summary, we can conclude that follow-up of these children, osteodensitometric measurements and monitoring of laboratory parameters are extremely important, as bone abnormalities can occur in leukemia patients. Orv Hetil. 2020; 161(49): 2086–2093.

Reduced Bone Mineral Density in Long-term Survivors of Childhood Acute Lymphoblastic Leukemia

1998 ◽  
Vol 20 (3) ◽  
pp. 234-240 ◽  
Author(s):  
Pekka Arikoski ◽  
Jorma Komulainen ◽  
Raimo Voutilainen ◽  
Pekka Riikonen ◽  
Markku Parviainen ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Acute Lymphoblastic Leukemia ◽  
Bone Mineral ◽  
Lymphoblastic Leukemia ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Mineral Density ◽  
Long Term Survivors

scholarly journals The proportion of bone mineral density in children with high risk acute lymphoblastic leukemia after 6- and 12-month chemotherapy maintenance phase

2016 ◽  
Vol 50 (6) ◽  
pp. 365
Author(s):  
Mira Christiyani Santoso ◽  
Endang Windiastuti ◽  
Alan R. Tumbelaka
Keyword(s):  
Bone Mineral Density ◽  
Acute Lymphoblastic Leukemia ◽  
High Risk ◽  
Bone Mineral ◽  
Calcium Ion ◽  
Mineral Metabolism ◽  
Lymphoblastic Leukemia ◽  
Maintenance Phase ◽  
Z Score ◽  
Mineral Density

Background Low bone mineral density (BMD) value is one of the current concerns in acute lymphoblastic leukemia (ALL) patients. Some risk factors including use of chemotherapeutic drugs, nutritional status, phy sical activities, and progression of disease are suspected as the predisposing factors for development of osteopenia and osteoporosis.Objectives To obtain the proportion of BMD z-score, level of calcium ions, and 25 (OH)D3 in children 'With high risk ALL after 6 and 12 months chemotherapy maintenance phase.Methods We conducted a cross-sectional comparative study from May 2008 to May 2010. Subjects were high risk ALL patients aged 5-18 years old who had completed the 6 or 12 months chemotherapy maintenance phase. We measured 25 (OH) D3 level, calcium ion level, and BMD using electro chemi-luminescence immunoassay, ion selective electrode, and dual x-ray absorptiometry, respectively.Results There were 40 subjects who enrolled this study. The incidence of hypocalcemia and vitamin D deficiency were 33/40 and 40/40, respectively. The mean calcium ion levels, 25 (OH)D3 level, and BMD z􀁏score values in six months groups were 1.1 (0.1 SD) mmol/L, 21.3 (2 SD) ng/L, -0.7 (0.8 SD), respectively, while in the 12 months group, the values were 1.1 (0.0 SD) mmol/L, 21(2.2 SD) ng/L, -1.7 (0.6 SD), respectively (P=0.478). Body mass index (BMI) and corticosteroid cumulative dose is correlated \\lith the low BMD values in L1-L4.Conclusion The bone mineral metabolism disorder marked with the low levels of calcium, 25 (OH)D3 and osteopenia was observed in ALL patients who underwent chemotherapy. The proportion of the BMD z-score value, calcium ion level, and 25 (OH) D3 in the two groups were not statistically significant.

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