Bone mineral density in pediatric survivors of Hodgkin and non-Hodgkin lymphomas.

PURPOSE

To assess skeletal mass in survivors of childhood Hodgkin disease (HD) and non-Hodgkin lymphoma (NHL) 1-5 years after treatment, and to identify potential risk factors influencing bone mineral density (BMD).

PATIENTS/METHODS: This cross-sectional study was conducted in a cohort of 43 survivors (HD=31; NHL=12); mean age: 16.21 ± 4.4. Total body bone mineral content (TBMC) and density (TBBMD), and lumbar spine density (LSBMD) were determined using dual-energy X-ray absorptiometry.

RESULTS

Three of all 43 patients developed low BMD. No significant differences in height, weight, and/or BMD Z-scores were found between HD and NHL survivors, children who received and did not receive radiotherapy, and the groups with different chemotherapeutic blocks. No differences were noted between the Z-scores of BMC (mean ± SD: 0.31 ± 1.29 vs. -0.089 ± 0.61, p=0.165), TBBMD (mean ± SD: -0.32 ± 1.21 vs. -0.27 ± 0.91, p=0.76), or the LSBMD (mean ± SD: -0.183 ± 1.54 vs. -0.17 ± 0.87, p=0.637) in subgroups, in accordance with time after therapy (subgroup I<2 years and subgroup II>2 years after treatment). In HD survivors, age at diagnosis only affected the TBBMD Z-score (a decrease of 0.127 in total BMD Z-score per each year, R²=0.999, p<0.001).

CONCLUSIONS

Childhood lymphoma survivors demonstrate no significant deficits in bone mass and tend to maintain their BMD within the normal range when presenting during one to five years' follow-up. However, this specific group requires longitudinal investigation to assess the pattern of peak bone mass achievement and the risk of future bone loss.