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01-02-2015 | Original Article

Bone mineral density after childhood cancer in 346 long-term adult survivors of childhood cancer

Authors: M. A. H. den Hoed, B. C. Klap, M. L. te Winkel, R. Pieters, M. van Waas, S. J. C. M. M. Neggers, A. M. Boot, K. Blijdorp, W. van Dorp, S. M. F. Pluijm, M. M. van den Heuvel-Eibrink

Published in: Osteoporosis International | Issue 2/2015

Abstract

Summary

More than 45 % of long-term childhood cancer survivors (CCS) were diagnosed with osteopenia. Our data suggest that greater awareness for osteopenia is warranted in long-term CCS, especially in survivors who are older than 30 years, male, and underweight and were treated with cranial-spinal radiotherapy and/or steroids.

Introduction

Osteopenia is a potential complication of childhood cancer treatment, but the magnitude of this problem in survivors is unknown. We examined (determinants of) bone mineral density (BMD) status in long-term survivors of adult childhood cancer.

Methods

This retrospective single-centre cohort study included 346 subjects with the most common types of childhood cancer. Subjects had a median age at diagnosis of 7.0 years (range 0.1–16.8 years), a median age at follow-up of 24.5 years (range 18.0–47.6 years) and a median follow-up time of 16.7 years (range 5.6–39.9 years). Total body BMD (BMD_TB) and BMD of the lumbar spine (BMD_LS) were measured by dual X-ray absorptiometry. Osteopenia was defined as BMD standardized deviation score (SDS) below −1.

Results

Survivors had a lower BMD_TB and BMD_LS (mean SDS −0.55; p < 0.001 and −0.30; p < 0.001, respectively) as compared to healthy peers. Osteopenia (BMD_TB and/or BMD_LS) was present in 45 % of the survivors. Multivariate logistic regression analyses identified age at diagnosis <12 years, age >30 years at follow-up, male gender, underweight at follow-up and treatment with cranial-spinal radiotherapy or prednisone as independent prognostic factors for osteopenia.

Conclusions

This large cohort of childhood cancer survivors identified osteopenia in 45 % of CCS. This indicates that greater awareness is warranted, especially in survivors who are older than 30 years, male, have underweight and were treated with cranial-spinal radiotherapy and/or steroids.

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Title: Bone mineral density after childhood cancer in 346 long-term adult survivors of childhood cancer
Authors: M. A. H. den Hoed
B. C. Klap
M. L. te Winkel
R. Pieters
M. van Waas
S. J. C. M. M. Neggers
A. M. Boot
K. Blijdorp
W. van Dorp
S. M. F. Pluijm
M. M. van den Heuvel-Eibrink
Publication date: 01-02-2015
Publisher: Springer London
Published in: Osteoporosis International / Issue 2/2015
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-014-2878-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Bone mineral density after childhood cancer in 346 long-term adult survivors of childhood cancer

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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