NIAGARA-ON-THE-LAKE, On-tario, CanadaWith the increasing success in the
treatment of childhood leukemia and other cancers, possible long-term
problems need to be addressed, said Sue Kaste, DO, St. Jude Children’s
"One particularly worrisome sequela is the decrease in bone density that
we see in this population," she said at the 7th International Conference for
Long-Term Complications of Treatment of Children and Adolescents for Cancer,
hosted by Roswell Park Cancer Institute (abstract 3). "It appears that at a
time when children should be building their bones, bone mineral deficits may
occur in this survivor population. Physicians must be mindful of this risk
when following these patients."
Patients who return for annual evaluation in the Bone Marrow
Transplantation Clinic at St. Jude undergo quantitative computed tomography (QCT)
and dual-energy x-ray absorptiometry (DEXA). Dr. Kaste reviewed the results
of these tests obtained from March 2001 to November 2001.
Of 59 patients who visited the clinic during the study months, 29 were
male and 30 were female. Their average age at bone marrow transplantation (BMT)
was 10.9 years (range, 1.6 to 20.4). Their median age at the time of study
was 15.9 years (range, 4.4 to 27.2).
The participants received a bone mineral density (BMD) z-score of their
lumbar spine for each test. The median BMD score from QCT was -.89 (range,
-4.06 to 3.05); for DEXA, it was -1.1 (range,
-3.9 to 3.6). Any BMD z-score below -2 standard deviations was considered
indicative of osteoporosis.
By QCT, 12 patients showed evidence of osteoporosis, and based on the DEXA
scan, 7 patients were afflicted. Females were more severely affected than
males (P = .0137).