Bone mineral density in pediatric survivors of Hodgkin and non-Hodgkin lymphomas

Purpose: To assess skeletal mass in survivors of childhood Hodgkin disease (HD) and non-Hodgkin lymphoma (NHL) 1-5 years after treatment, and to identify potential risk factors influencing bone mineral density (BMD). Patients/ methods: This cross-sectional study was conducted in a cohort of 43 survivors (HD = 31; NHL = 12); mean age: 16.21 +/- 4.4. Total body bone mineral content (TBMC) and density (TBBMD), and lumbar spine density (LSBMD) were determined using dual-energy X-ray absorptiometry. Results: Three of all 43 patients developed low BMD. No significant differences in height, weight, and/ or BMD Z-scores were found between HD and NHL survivors, children who received and did not receive radiotherapy, and the groups with different chemotherapeutic blocks. No differences were noted between the Z-scores of BMC (mean +/- SD: 0.31 +/- 1.29 vs. 0.089 +/- 0.61, p = 0.165), TBBMD (mean +/- SD: 0.32 +/- 1.21 vs. -0.27 +/- 0.91, p = 0.76), or the LSBMD (mean +/- SD: -0.183 +/- 1.54 vs. -0.17 +/- 0.87, p = 0.637) in subgroups, in accordance with time after therapy (subgroup I < 2 years and subgroup II > 2 years after treatment). In HD survivors, age at diagnosis only affected the TBBMD Z-score (a decrease of 0.127 in total BMD Z-score per each year, R-2 = 0.999, p < 0.001). Conclusions: Childhood lymphoma survivors demonstrate no significant deficits in bone mass and tend to maintain their BMD within the normal range when presenting during one to five years' follow-up. However, this specific group requires longitudinal investigation to assess the pattern of peak bone mass achievement and the risk of future bone loss. (C) 2014 Medical University of Bialystok. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.