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Osteoporosis International

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Open Access 01-02-2021 | Computed Tomography | Original Article

Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures

Authors: J. Bodden, D. Sun, G. B. Joseph, L.-W. Huang, C. Andreadis, M. Hughes-Fulford, T. F. Lang, T. M. Link

Published in: Osteoporosis International | Issue 2/2021

Abstract

Summary

Information on bone loss in treated non-Hodgkin’s lymphoma patients is limited. In this study, we used CT to analyze bone loss as well as prevalent and incident fractures. We found severe bone loss, a high rate of fractures, and a novel association between bone loss and the international prognostic index.

Introduction

To investigate bone loss and fracture risk in non-Hodgkin-lymphoma (NHL) patients by (i) comparing treatment-related vertebral density (VD) loss in NHL patients with control subjects and (ii) investigating associations of VD loss versus fracture risk. Further, associations of VD loss and clinical parameters were investigated.

Methods

VD of 123 NHL patients was measured pre- and post-treatment in the L1, L2, and L3 vertebrae in routine computed tomography (CT) scans, performed between Jan 2016 and Mar 2017. Control measurements (n = 52) were obtained from CT colonographies between Sept 2003 and Sept 2017 and their subsequent follow-up-exams (10–137 months).

Prevalent and incident (between baseline and follow-up) fractures were assessed in all subjects, and VD loss per year was calculated. Linear regression models were used to (i) compare VD loss between patients and controls and (ii) identify associations between VD loss and clinical parameters. Using logistic regression models, ORs for fractures per SD change in VD were assessed in patients. Analyses were adjusted for age, sex, and contrast application.

Results

NHL patients experienced significantly greater VD_L1–3 loss than controls (P = 0.003), and greater VD_L1–3 loss was associated with a greater likelihood of incident fractures (OR, [95%-CI], P 1.90, [1.03, 3.51], 0.04). Patients with an initial international prognostic index (IPI) of 5 suffered significantly greater VD loss compared with an IPI of 0 (P = 0.01).

Conclusion

Using VD measurements in routine CT scans, substantial vertebral bone loss in NHL patients could be documented with a high incidence of fractures.

SEER Cancer Stat Facts: Non-Hodgkin lymphoma. National Cancer Institute. Bethesda, MD. https://seer.cancer.gov/statfacts/html/nhl.html. Accessed 10/11 2019

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Title: Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures
Authors: J. Bodden
D. Sun
G. B. Joseph
L.-W. Huang
C. Andreadis
M. Hughes-Fulford
T. F. Lang
T. M. Link
Publication date: 01-02-2021
Publisher: Springer London
Keywords: Computed Tomography
Non-Hodgkin Lymphoma
Computed Tomography
Osteoporosis
Osteoporosis
Published in: Osteoporosis International / Issue 2/2021
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-020-05577-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures

Abstract

Summary

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

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