Tragiannidis A, Dokos Ch, Sidi V, Papageorgiou Th, Koliouskas D, Karamouzis M, Papastergiou Ch, Tsitouridis I, Katzos G, Rousso I, Athanassiadou-Piperopoulou F
Hippokratia. 2011 Jan;15(1):43-7.
Children with haematological malignancies such as acute lymphoblastic leukaemia (ALL) may have alteration of bone mineral metabolism therefore increased risk for osteopenia and osteoporosis.
The purpose of this study was to examine the alterations of bone mineral metabolism in two groups of children (n=42) according to immunophenotyping (B-cell type, T-cell type) both quantitative (bone mineral density z-scores) and qualitative (serum osteocalcin - OC and carboxyl-terminal telopeptide of human type I collagen - ICTP) during diagnosis (T=0), after the intensified chemotherapy period (T=0.5) and the consolidation period (T=1).
According to our results 15 patients had osteopenia and 1 child developed osteoporosis at T=0.5 and 13 patients had osteopenia at T=1. Mean BMD z-score was significantly decreased in both groups during chemotherapy and especially statistically significant decline of T-cell type ALL group compared with B-cell type ALL patients. OC mean level remains in low levels for both groups reaching in plateau during chemotherapy and ICTP level was increased in T-cell type ALL group of patients compared with B-cell type in both periods of chemotherapy.
It seems that not only the combination of chemotherapeutic agents but also the cell lineage of ALL are important parameters of altering bone mineral metabolism.
患有血液系统恶性肿瘤（如急性淋巴细胞白血病（ALL））的儿童可能存在骨矿物质代谢改变，因此患骨质减少和骨质疏松的风险增加。
本研究的目的是根据免疫表型（B细胞型、T细胞型），在诊断时（T = 0）、强化化疗期后（T = 0.5）和巩固期（T = 1），对两组儿童（n = 42）的骨矿物质代谢改变进行定量（骨密度z评分）和定性（血清骨钙素 - OC和I型胶原羧基末端肽 - ICTP）检查。
根据我们的结果，在T = 0.5时，15例患者患有骨质减少，1例儿童发生骨质疏松，在T = 1时，13例患者患有骨质减少。化疗期间两组的平均骨密度z评分均显著降低，尤其是T细胞型ALL组与B细胞型ALL患者相比有统计学意义的下降。两组的OC平均水平在化疗期间均保持在低水平并达到平稳状态，在两个化疗期，T细胞型ALL组患者的ICTP水平均高于B细胞型。
似乎不仅化疗药物的联合使用，而且ALL的细胞谱系都是改变骨矿物质代谢的重要参数。
