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淋巴瘤常用一线治疗后骨质疏松风险增加:一项丹麦全国队列研究。

Increased risk of osteoporosis following commonly used first-line treatments for lymphoma: a Danish Nationwide Cohort Study.

机构信息

Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.

Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.

出版信息

Leuk Lymphoma. 2020 Jun;61(6):1345-1354. doi: 10.1080/10428194.2020.1723015. Epub 2020 Feb 11.

Abstract

High-dose prednisolone is used in first-line treatment for lymphoma, but the potential adverse impact on bone health is unclear. Danish patients with diffuse large B-cell lymphoma or follicular lymphoma diagnosed between 2000 and 2012 were matched to the background population. Osteoporotic events (osteoporosis treatment or low-energy fracture) were identified using the Danish National Patient Registry and Prescription Registry. In total, 2589 patients and 12,945 controls were included. Lymphoma patients had increased risk of osteoporotic events compared to the matched population (hazard ratio 1.61 [95% confidence interval 1.40;1.84]). The 5- and 10-year cumulative risks of osteoporotic events for lymphoma patients were 10.0% [8.6;11.4] and 16.3% [13.8;18.7], whereas corresponding risks in the background population were 6.8% [6.3;7.3] and 13.5% [12.4;14.6]. Patients without osteoporotic event in the first two years after treatment were not at higher risk of osteoporotic events in subsequent years. Risk factors for osteoporotic events were female sex and age >70 years.

摘要

大剂量泼尼松龙被用于治疗淋巴瘤的一线治疗,但对骨骼健康的潜在不利影响尚不清楚。丹麦患者患有弥漫性大 B 细胞淋巴瘤或滤泡性淋巴瘤,诊断时间为 2000 年至 2012 年,与背景人群相匹配。骨质疏松症事件(骨质疏松症治疗或低能量骨折)使用丹麦国家患者登记处和处方登记处确定。共有 2589 名患者和 12945 名对照者被纳入研究。与匹配人群相比,淋巴瘤患者发生骨质疏松症事件的风险增加(风险比 1.61 [95%置信区间 1.40;1.84])。淋巴瘤患者在 5 年和 10 年内发生骨质疏松症事件的累积风险分别为 10.0% [8.6;11.4]和 16.3% [13.8;18.7],而在背景人群中,相应的风险分别为 6.8% [6.3;7.3]和 13.5% [12.4;14.6]。在治疗后的前两年没有骨质疏松症事件的患者,在随后的几年中发生骨质疏松症事件的风险没有更高。骨质疏松症事件的危险因素是女性和年龄>70 岁。

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