Kaste Sue C
Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Pediatr Blood Cancer. 2008 Feb;50(2 Suppl):469-73; discussion 486. doi: 10.1002/pbc.21408.
For many childhood cancer survivors, the future will hold years of pain and disability due to skeletal toxicities resulting from disease, its treatment and predisposing familial factors that contribute to the development of bone mineral density (BMD) deficits and osteonecrosis. Some technical limitations of imaging methods designed to assess BMD in skeletally mature adult patients are amplified when used to assess bone density in growing children and adolescents. Identifying changes in bone marrow that are associated with disease or treatment, and differentiating these that may heal in comparison to those likely to progress, have not been studied extensively in children. Until recently, little emphasis has been placed on the definition, characterization and prospective monitoring of these two major skeletal toxicities in pediatric patients, despite the growing attention being paid to the prevalence and severity of osteoporosis in adults. Further, the disease definitions established for adults are unlikely to apply to growing children. This presentation will discuss many of the issues related to defining, identifying, and classifying deficits in BMD and osteonecrosis, and will likely raise more issues than it answers.
对于许多儿童癌症幸存者来说，由于疾病、其治疗以及导致骨矿物质密度（BMD）缺陷和骨坏死发展的家族易患因素所引起的骨骼毒性，未来将面临多年的疼痛和残疾。旨在评估骨骼成熟成年患者BMD的成像方法的一些技术局限性，在用于评估生长中的儿童和青少年的骨密度时会被放大。识别与疾病或治疗相关的骨髓变化，并区分哪些可能愈合，哪些可能进展，在儿童中尚未得到广泛研究。直到最近，尽管成人骨质疏松症的患病率和严重程度越来越受到关注，但对于儿科患者这两种主要骨骼毒性的定义、特征描述和前瞻性监测却很少受到重视。此外，为成人制定的疾病定义不太可能适用于正在成长的儿童。本报告将讨论与BMD缺陷和骨坏死的定义、识别和分类相关的许多问题，并且可能提出的问题比回答的更多。
