High Incidence of Vertebral Fractures in Children With Acute Lymphoblastic Leukemia 12 Months After the Initiation of Therapy
| Autor: | Stephanie A. Atkinson, Nazih Shenouda, Celia Rodd, Leanne M Ward, Kathryn Williams, Robert Stein, Shayne Taback, Mary-Ann Matzinger, David Dix, Jacqueline Halton, David Stephure, Tim Ramsay, Frank Rauch, Paivi Miettunen, Beverly Wilson, Conrad V. Fernandez, Nathalie Alos, Elizabeth A. Cummings, Victor Lewis, John Du Vall Hay, Kerry Siminoski, Sharon Abish, Caroline Laverdière, Ronald D. Barr, David A. Cabral, Brian C. Lentle, Robert B. Couch, Sara J. Israels, Elizabeth Cairney, Ronald Grant |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Time Factors Adolescent Bone density Osteoporosis Article Bone Density medicine Back pain Humans Child Glucocorticoids Childhood Acute Lymphoblastic Leukemia Retrospective Studies business.industry Incidence Incidence (epidemiology) Infant Retrospective cohort study Odds ratio Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Surgery Logistic Models Methotrexate Oncology Child Preschool Spinal Fractures Female medicine.symptom Complication business |
| Zdroj: | Paediatrics Publications |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2011.40.4830 |
| Popis: | Purpose Vertebral fractures due to osteoporosis are a potential complication of childhood acute lymphoblastic leukemia (ALL). To date, the incidence of vertebral fractures during ALL treatment has not been reported. Patient and Methods We prospectively evaluated 155 children with ALL during the first 12 months of leukemia therapy. Lateral thoracolumbar spine radiographs were obtained at baseline and 12 months. Vertebral bodies were assessed for incident vertebral fractures using the Genant semiquantitative method, and relevant clinical indices such as spine bone mineral density (BMD), back pain, and the presence of vertebral fractures at baseline were analyzed for association with incident vertebral fractures. Results Of the 155 children, 25 (16%; 95% CI, 11% to 23%) had a total of 61 incident vertebral fractures, of which 32 (52%) were moderate or severe. Thirteen (52%) of the 25 children with incident vertebral fractures also had fractures at baseline. Vertebral fractures at baseline increased the odds of an incident fracture at 12 months by an odds ratio of 7.3 (95% CI, 2.3 to 23.1; P = .001). In addition, for every one standard deviation reduction in spine BMD Z-score at baseline, there was 1.8-fold increased odds of incident vertebral fracture at 12 months (95% CI, 1.2 to 2.7; P = .006). Conclusion Children with ALL have a high incidence of vertebral fractures after 12 months of chemotherapy, and the presence of vertebral fractures and reductions in spine BMD Z-scores at baseline are highly associated clinical features. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|