Bone mineralization in women following successful treatment of Hodgkin's disease

Redman, John R.; Bajorunas, Daiva R.; Wong, George Y.; McDermott, Katherine A.; Gnecco, Clare; Schneider, Robert J.; Lacher, Mortimer J.; Lane, Joseph M.

doi:10.1016/0002-9343(88)90504-9

Cited by 43 publications

(30 citation statements)

References 24 publications

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“…There are reports of decreased bone mineral density in long-term survivors of Hodgkin's disease, both men 18 and women, 19,20 with possible causes being treatment-related hypogonadism, direct effect of chemotherapy on bone, or an effect of high-dose glucocorticoid on bone. Osteoporosis and vertebral fractures may occur in children with newly diagnosed acute lymphoblastic leukemia and following its treatment.…”

Section: Discussionmentioning

confidence: 99%

Bone mineral density in patients undergoing bone marrow transplantation for myeloid malignancies

Bhatia

Ramsay

Weisdorf

et al. 1998

Bone Marrow Transplant

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Summary:Bone mineral density (BMD) was measured in 23 patients who had undergone bone marrow transplantation (BMT) at the University of Minnesota for myeloid leukemia. The median age at BMT was 22 years (range 3-53) and the median age at assessment of BMD was 27 years (range 4-56). Total body BMD was measured a median of 2 years (range 1-10) after BMT using Dual Photon X-ray Absorptiometry (DEXA). BMD was measured in g/cm 2 , with results expressed as percent of normal values and as Z (standard deviation) scores. Patients were categorized into two groups (pediatric and adult) according to age at BMT (р18 years vs Ͼ18 years). Total body BMD of patients in the pediatric age group was significantly decreased (median Z-score ؊0.5) compared to the adult population (median Z-score 0.0, P = 0.03). No association was observed between BMD and time elapsed since BMT, type of conditioning regimen, gonadal function, steroid intake or graft-versus-host disease. Investigation of decreased BMD in children with AML following BMT is needed to determine the metabolic basis, long-term implications, appropriate preventive measures and potential interventions. Keywords: bone mineral density; bone marrow transplantation; myeloid leukemia Bone marrow transplantation is now a well accepted therapeutic modality for hematologic and nonhematologic malignancies as well as certain non-malignant disorders. 1-3With improved survival following BMT, increasing importance is now being placed upon long-term effects of therapy. Decreased bone mineral density (BMD) is a well known complication of steroid administration 4 and has occasionally been reported to follow treatment with methotrexate. [5][6][7] Moreover, cranial irradiation 8,9 and growth hormone deficiency might be associated with decreased bone mineral density.10 Sensitive methods are needed to demonstrate sub- tle changes in bone accurately and assess therapeutic measures to correct demineralization. Several clinical and laboratory methods are typically used to assess osteopenia, but they have shortcomings. Conventional radiologic methods fail to detect decreases in bone mineral of less than 30 to 40%.11 Safe and accurate techniques are now available for measuring bone mass including single photon absorptiometry (SPA), dual photon absorptiometry (DPA), quantitative computed tomography (QCT), and the dual energy X-ray absorptiometry (DEXA), all of which are superior to standard radiographs.12 These techniques are the most accurate measures of bone mass and assessment of fracture risk.This paper reports the results of total body BMD measured using DEXA in 23 patients who underwent BMT at the University of Minnesota for myeloid malignancies. Materials and methods Study subjectsStudy subjects consisted of 23 patients who had undergone BMT for myeloid malignancies at the University of Minnesota between 1985 and 1995. Eligibility criteria for the BMD study included: (1) BMT for acute or chronic myelogenous leukemia; (2) no systemic illness lasting more than 2 weeks, 6 months prior to the BMD ...

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Section: Discussionmentioning

confidence: 99%

Bone mineral density in patients undergoing bone marrow transplantation for myeloid malignancies

Bhatia

Ramsay

Weisdorf

et al. 1998

Bone Marrow Transplant

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“…kin's disaw (Whitehead et al, 1982;Tsatsoulis et al, 1987), indicating that Leydig cell function had been compromised in at least some of the men studied. (Redman et al, 1988). In these women the reduction in cortical bone mass appears to be independent of chemotherapy-induced impairment of ovarian function and hence hypogonadism.…”

Section: S and Methodsmentioning

confidence: 97%

“…In these women the reduction in cortical bone mass appears to be independent of chemotherapy-induced impairment of ovarian function and hence hypogonadism. The reduction of integral BMD in addition to cortical BMC in women with premature ovarian failure following treatment of Hodgkin's disease (Redman et al, 1988) suggests that the reduced integral BMD is due to hypogonadism. However, the possibility that cortical and integral bone respond differently to hypogonadism is not in agreement with the finding that both cortical and integral BMD are reduced in men with severe hypogonadism due to idiopathic hypogonadotrophic hypogonadism (Finkelsstein et al, 1987) or hyperprolaminaemia (Greenspan et al, 1986).…”

Section: S and Methodsmentioning

confidence: 99%

Reduced bone mineral density in men following chemotherapy for Hodgkin's disease

Holmes

Whitehouse²,

Clark³

et al. 1994

Br J Cancer

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(Finkelstein et al., 1992). Men who undergo bilateral orchidectomy have a rapid and progressive loss of lumbar spine integral bone with time from orchidectomy (Stepan et al., 1989). In men with hyperprolactinaemic hypogonadism restoration of normal testicular function is assocated with a significant increase in cortical BMD (Greenspan et al., 1986). Siilarly, restoration of normal serum testosterone in men with idiopathic hypogonadotrophic hypogonadism is also associated with a significant increase in cortical BMD (Finkelstein et al., 1989 puted tomography. There was, however, a significant reduction in cortical and trabecular BMD in women with chemotherapy-induced premature ovarian failure compared with similarly treated women with normal ovarian function.We have studied BMD in 29 men in complete remission following treatment of Hodgkin's disease. We have studied the relationship between serum testosterone and BMD, and the effect on BMD of time elapsed since completion of chemotherapy, type of chemotherapy received and number of cycles of chemotherapy. S and methodsWe studied 29 caucasian men who had previously received chemotherapy for Hodg9in's disease. The study subjects were drawn from 50 consecutive men who presented to the Medical Oncology Dertment at Christie Hospital with newly diagosed Hodgkin's diseas and who were randomised to receive MVPP or hybrid chemotherapy. The 50 men took part in a study investigating the effects of MVPP and hybrid chemotherapy on gonadal function, and 29 of these men consented to have measurements of BMD performed. In the 29 men who underwent measurements of BMD, age at onset of chemotherapy was 31.0 ± 1.9 (mean + standard error, range 16.4-54.0) years. Twelve men had received a mean of 7.5 (range 5-8) cycles of MVPP (mustine 10 mg i.v. and vinblasin 10 mg i.v. on days 1 and 8 with procarbazine 150 mg daily and prednisolone 50 mg daily on days 1-14 of a 42 day cycle) and 17 men had received a mean of 7.5 (range 6-8) cycles of hybrid chemotherapy (vinblastine lOmgi.v. on day 1, with chlorambucil 1Omg daily, procarbazine 150 mg daily and prednisolone 50 mg daily on days 1-7, and etoposide 200mg m-2 i.v., viris 2 mg i.v. and doxorubicin 50 mg m-2i.v. on day 8 of a 28 day cycle). Twenty-four men received radiotherapy (15 to chest and mediastinum, eight to neck and one to axilla) but none in a radiation field which included the testes or the parts of the skeleton studied. All men were in complete remission at the time of study, and all had azoospermia.Blood samples were taken for estimation of serum testosterone, sex hormone-binding globulin (SHBG), LH and FSH. Seven men had blood samples taken on one occasion, 19 on two occasions and three on three occasions. There were therefore a total of 54 blood samples taken 2.7 ± 0.2

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“…Moreover, this counseling is recommended after treatment to monitor for premature menopause and initiation of calcium, vitamin D, bisphosphonates, and exercise for the treatment of bone demineralization [46].…”

Section: Female Fertilitymentioning

confidence: 99%

Therapy-Related Late Adverse Events in Hodgkin’s Lymphoma

et al. 2013

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Hodgkin's lymphoma (HL) is one of the most curable hematologic diseases with an overall response rate over 80%. However, despite this therapeutic efficacy, HL survivors show a higher morbidity and mortality than other people of the same age because of long-term therapy-related events. In the last decades, many efforts have been made to reduce these effects through the reduction of chemotherapy dose, the use of less toxic chemotherapeutic agents, and the introduction of new radiation techniques. In this paper, we will describe the main long-term effects related to chemotherapy and radiotherapy for HL, the efforts to reduce toxicity made in the last years, and the clinical aspects which have to be taken into consideration in the followup of these patients.

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Bone mineralization in women following successful treatment of Hodgkin's disease

Cited by 43 publications

References 24 publications

Bone mineral density in patients undergoing bone marrow transplantation for myeloid malignancies

Bone mineral density in patients undergoing bone marrow transplantation for myeloid malignancies

Reduced bone mineral density in men following chemotherapy for Hodgkin's disease

Therapy-Related Late Adverse Events in Hodgkin’s Lymphoma

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