Bone loss after childhood acute lymphoblastic leukaemia: an observational study with and without GH therapy
Författare
Summary, in English
OBJECTIVE: Bone mineral density (BMD) in survivors of acute lymphoblastic leukaemia (ALL) seems to vary with time, type of treatments and GH status. We aimed to evaluate BMD in ALL patients with growth hormone deficiency (GHD), with and without GH therapy. DESIGN: Case-control study. METHODS: 44 (21 women) GHD patients (median 25 years), treated with cranial radiotherapy (18-24 Gy) and chemotherapy and matched population controls were examined for BMD with DXA (Dual-energy X-ray absorptiometry). Two subgroups; with (0.5 mg/day) (n=16) and without GH therapy (n=13), and matched controls, were followed for 5 and 8 years, respectively. RESULTS: At baseline, no significant differences in BMD or Z-scores at femoral neck and L2-L4 were recorded (all P > 0.3). After another 8 years with GHD, Z-scores at femoral neck had decreased significantly compared to baseline (0.0 to -0.5; P<0.03), and became lower at femoral neck (P=0.05), and at L2-L4 (P<0.03), compared to controls. After 5 years of GH therapy only female ALL patients had a significantly lower femoral neck Z-scores (P=0.03). The female ALL patients reached an IGF-I level of -0.7 SD and in men the level was +0.05 SD. CONCLUSIONS: On average 25 years since diagnosis GH deficient ALL patients experienced a significant decrease in Z-scores at femoral neck and if Z-scores continuous to decrease there is a premature risk for osteoporosis. GH therapy was not shown to have a clear beneficial effect on BMD. Whether higher GH doses, particularly in women, will improve Z-scores needs further investigation.
Avdelning/ar
- Medicin/akutsjukvård, Lund
- Diabetes - Clinical Obesity
- Pediatrik, Lund
- Avdelningen för arbets- och miljömedicin
- EpiHealth: Epidemiology for Health
Publiceringsår
2011
Språk
Engelska
Sidor
695-703
Publikation/Tidskrift/Serie
European Journal of Endocrinology
Volym
164
Issue
5
Fulltext
Länkar
Dokumenttyp
Artikel i tidskrift
Förlag
Society of the European Journal of Endocrinology
Ämne
- Endocrinology and Diabetes
Status
Published
Forskningsgrupp
- Diabetes - Clinical Obesity
ISBN/ISSN/Övrigt
- ISSN: 1479-683X