Seland Mette, Smeland Knut B, Bjøro Trine, Falk Ragnhild S, Fosså Sophie D, Gjesdal Clara G, Godang Kristin, Holte Harald, Svartberg Johan, Syversen Unni, Bollerslev Jens, Kiserud Cecilie E
a National Advisory Unit on Late Effects After Cancer Treatment, Department of Oncology , Oslo University Hospital , Oslo , Norway.
b Department of Medical Biochemistry , Oslo University Hospital , Oslo , Norway.
Acta Oncol. 2017 Apr;56(4):590-598. doi: 10.1080/0284186X.2016.1267870. Epub 2017 Jan 12.
Few studies have assessed bone health in lymphoma survivors treated with high-dose therapy with autologous stem cell transplantation (HDT-ASCT). Therefore, we aimed to assess bone mineral density (BMD) at six different skeletal sites and to investigate associations between clinical factors and BMD in these survivors.
Eligible lymphoma survivors were aged ≥18 years at diagnosis and at HDT-ASCT given between 1987 and 2008. Participants responded to questionnaires, blood samples were drawn, and a dual energy X-ray absorptiometry (DXA) was performed. Mean Z-score was applied for assessment of BMD in relation to age. Prevalence of Z-scores ≥-1, between -1 and -2, and ≤-2 is reported for each measurement site and for the lumbar spine, femoral neck, and hip in combination. Likewise, T-scores were applied to assess the prevalence of normal BMD (≥-1), osteopenia (between -1 and -2.5), and osteoporosis (≤-2.5).
We included 228 lymphoma survivors, of whom 62% were males. The median age at survey was 56 years, and median observation time from HDT-ASCT was eight years. Among males, Z-scores were lower at the left femoral neck and higher at the ultra-distal (UD) radius and whole body compared to the Lunar reference database. In females, Z-scores were lower at UD radius and one-third (33%) radius and higher at the whole body. Using a classification based on Z-scores at the lumbar spine, femoral neck, and hip in combination, 25% of males and 16% of females had Z-scores <-1 and >-2, while 8% and 6% had Z-scores ≤-2. According to T-scores, 35% of males and 41% of females had osteopenia, while 8% and 13% had osteoporosis, respectively.
BMD was close to normal for age in this population of long-term lymphoma survivors treated with HDT-ASCT.
很少有研究评估接受高剂量自体干细胞移植治疗（HDT-ASCT）的淋巴瘤幸存者的骨骼健康状况。因此，我们旨在评估六个不同骨骼部位的骨密度（BMD），并调查这些幸存者临床因素与骨密度之间的关联。
符合条件的淋巴瘤幸存者在诊断时年龄≥18岁，且在1987年至2008年间接受HDT-ASCT。参与者回答问卷，采集血样，并进行双能X线吸收测定（DXA）。采用平均Z值评估与年龄相关的骨密度。报告每个测量部位以及腰椎、股骨颈和髋部联合测量时Z值≥-1、在-１至-2之间和≤-2的患病率。同样，采用T值评估骨密度正常（≥-1）、骨量减少（在-1至-2.5之间）和骨质疏松（≤-2.5）的患病率。
我们纳入了228名淋巴瘤幸存者，其中62%为男性。调查时的中位年龄为56岁，自HDT-ASCT后的中位观察时间为8年。与Lunar参考数据库相比，男性中，左股骨颈的Z值较低，而超远端（UD）桡骨和全身的Z值较高。女性中，UD桡骨和三分之一（33%）桡骨处的Z值较低，而全身的Z值较高。根据腰椎、股骨颈和髋部联合测量的Z值进行分类，25%的男性和16%的女性Z值＜-1且＞-2，而8%和6%的Z值≤-2。根据T值，35%的男性和41%的女性患有骨量减少，而分别有8%和13%患有骨质疏松。
在接受HDT-ASCT治疗的这群长期淋巴瘤幸存者中，骨密度接近同龄人正常水平。
