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 Research Hospital.
"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).