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Title: | Assessment of bone mineral density and risk factors in children completing treatment for acute lymphoblastic leukemia |
Authors: | Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı. Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı. 0000-0003-0710-5422 Güneş, Adalet Meral Can, Erkan Sağlam, Halil İlçöl, Yeşim Özarda Baytan, Birol C-7392-2019 ABB-7412-2020 AAL-8873-2021 24072843300 36058591600 35612700100 35741320500 6506622162 |
Keywords: | Childhood Acute leukemia Bone mineral density Growth-factor-I Long-term survivors Binding-proteins Chemotherapy Therapy Hormone Dietary Calcium Oncology Hematology Pediatrics |
Issue Date: | Apr-2010 |
Publisher: | Lippincott Williams & Wilkins |
Citation: | Güneş, A. M. vd. (2010). "Assessment of bone mineral density and risk factors in children completing treatment for acute lymphoblastic leukemia". Journal of Pediatric Hematology Oncology, 32(3), 102-107. |
Abstract: | Background: Reduced bone mineral density and increased fracture risk have been reported in children with cancer. In this study, we aimed to determine the growth and bone mineral density (BMD) of the children off chemotherapy for acute lymphoblastic leukemia, and the probable risk factors. Procedure: The age, anthropometric measurements, lumbar spine BMDs were recorded in 70 children. The risk factors on BMD; daily calcium intake, the time interval from the completion of the chemotherapy, cranial radiotherapy, cumulative steroid dose, decrease in physical activity were investigated. Serum calcium, phosphate, alkaline phosphates, magnesium, insulin-like growth factor-1 (IGF-1) and 25 (OH) vitamin D levels were determined. Results: The mean height percentile at the time of diagnosis was decreased from the value of 53 to a value of 47 at the beginning of the study (P = 0.071). Of them; 44% had osteoporosis, 41% had osteopenia, and the rest had normal BMD. BMD z-scores were decreased during the first 2 years from the completion of the treatment. There was a positive correlation between BMD z-scores and daily calcium intake (CC = 0.366, P = 0.0015). A negative correlation was determined between the time spent on TV and computers and BMD z-scores (CC = -0.464, P = 0.0019). Serum IGF-1 and 25 (OH) vitamin D levels of patients were significantly lower than controls (P = 0.033). Conclusions: Our data revealed that 85% of the survivors had bone mineralization defect. BMDs and z scores were decreased during the first 2 years from the completion of the treatment and then gradually began to increase. The most important risk factor for decreased BMD was low daily calcium intake. Therefore, patients and their families should be encouraged to take sufficient amount of calcium. Prophylactic vitamin D may also be supplemented. |
URI: | https://doi.org/10.1097/MPH.0b013e3181d32199 https://pubmed.ncbi.nlm.nih.gov/20216235/ http://hdl.handle.net/11452/23120 |
ISSN: | 1077-4114 1536-3678 |
Appears in Collections: | Scopus Web of Science |
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