Kaitlyn D’Onofrio

DocwireNews

A new cross-sectional study examined factors associated with reduced <a href="https://www.docwirenews.com/abstracts/rheumatology-abstracts/association-between-drug-treatments-for-patients-with-osteoporosis-and-overall-mortality-rates-a-meta-analysis/">bone mineral density</a> (BMD) and the risk of fracture in long-term <a href="https://www.docwirenews.com/docwire-pick/battled-childhood-cancer/">survivors of childhood leukemia and lymphoma</a>.&ldquo;Survivors of childhood leukemia/lymphoma are at increased risk for reduced bone mineral density (BMD),&rdquo; the researchers explained. &ldquo;The authors sought to determine the frequency of reduced BMD detected by off&#8208;therapy surveillance, factors associated with reduced BMD, and the association of reduced BMD with fractures.&rdquo;Their findings were published in <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.32512?referrer_access_token=yPXOSptGSBjoL9ycIpNEK04keas67K9QMdWULTWMo8N7i0jiMqR_s0t5mWMYAjRQAeodJeUOUYPAZVzHRUsiifZV4JGKb8EGgARQq2lfeLzAdeQGpuQMxKYXtbFM9Qu4kaFKb8jkQG1G-e7T2wJ6lw%3D%3D">Cancer</a>.The study included childhood leukemia/lymphoma survivors attending two survivorship clinics for routine, guideline-recommended service from Jan. 1, 2004, to Aug. 31, 2016. Patients were eligible based on the following factors:<ul>
<li>Received a cancer diagnosis at age &lt; 20 years</li>
<li>Underwent a routine dual&#8208;energy x&#8208;ray absorptiometry (DXA) scan two years or longer following completion of cancer therapy</li>
<li>Did not have a precancer condition affecting BMD</li>
</ul>Patients with a DXA scan less than two years before completing cancer therapy were excluded because this would not be considered routine surveillance. The researchers height-for-weight adjusted lumbar spine BMD z-scores. Low BMD was defined as &gt; 1 SD below age-, sex-, and race-matched norms, and very low BMD was defined as &gt; 2 SDs below the same norms. Medical records were queried for data on treatment, chronic conditions, and fracture.Final analysis included 542 patients (mean age [range], 15.5 [4.4-52.2] years; 51.5% were female) who were six (range, 2.0-35.1) years post-therapy. Of the total cohort, 116 sustained a post-therapy fracture. Low BMD and very low BMD in the lumbar spine was present in 17.2% and 3.5%, respectively, of survivors. However, subgroup analyses yielded significant between-group differences: in the cohort of survivors aged between 15 and 19 years, 10.8% had very low BMD. Multivariable analyses found the following factors to be significantly associated with low BMD: older age at diagnosis, white race, and being underweight. Survivors with low BMD were more likely to sustain nondigit fractures (odds ratio, 2.2; 95% CI, 1.3&#8208;3.7) and specifically long&#8208;bone fractures (odds ratio, 2.7; 95% CI, 1.5&#8208;4.7).&ldquo;We observed an association between low BMD and post-therapy fractures, emphasizing the clinical importance of DXA surveillance,&rdquo; the authors wrote in their conclusion. &ldquo;Future studies are needed to investigate long-term fracture risk and interventions to prevent fractures in the growing population of older adult childhood cancer survivors.&rdquo;

Jayme Locke, MD, MPH

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A new cross-sectional study examined factors associated with reduced bone mineral density (BMD) and the risk of fracture in long-term survivors of childhood leukemia and ...

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