Skeletal adverse events in childhood cancer survivors: An Adult Life after Childhood Cancer in Scandinavia cohort study

Abstract

The dynamic growth of the skeleton during childhood and adolescence renders it vulnerable to adverse effects of cancer treatment. The lifetime risk and patterns of skeletal morbidity have not been described in a population-based cohort of childhood cancer survivors. A cohort of 26 334 1-year cancer survivors diagnosed before 20 years of age was identified from the national cancer registries of Denmark,

Osteoporosis in Childhood Cancer Survivors: Physiopathology, Prevention, Therapy and Future Perspectives

“…Radiotherapy can induce damage to the hypothalamic–pituitary axis that results in growth hormone (GH) deficiency and hypogonadism, which prevent bone growth and mineral acquisition [ 65 ]. Low BMD in childhood and adolescence can lead to OP in adults along with fragility fractures and other skeletal adverse events, such as bone pain and bone deformity resulting in disability and poor quality of life [ 66 ]. Bone mineral density reduction has been reported for several pediatric cancers [ 44 , 67 , 68 ] such as ALL [ 69 , 70 ], lymphomas, neuroblastoma [ 71 ], and as a complication after HSCT.…”

“…Cancer therapies expose patients to risk of developing long-term sequelae. Bone health is frequently involved and often accompanied by bone pain, growth impairment, and fragility fractures which may cause disability and poor quality of life [ 66 ]. The assessment of this aspect in CCS during therapy and after cessation of treatment as well as a long-term follow-up is necessary to maintain bone health in these patients.…”

Skeletal Outcomes in Children and Young Adults with Glomerular Disease

“…Third, we implemented a cancer diagnosis exclusion because of established skeletal morbidity in survivors of childhood cancer. 32…”

Long-term musculoskeletal side effects in patients with neuroblastoma who have completed specific therapy (case reports and literature review)

“…Описание ОПЭ со стороны костно-мышечной системы в литературе в основном представлено пациентами с опухолями центральной нервной системы (ЦНС), костей скелета и злокачественными гематологическими заболеваниями, при которых высокая частота развития ортопедических последствий связана с применением высоких доз глюкокортикостероидов в рамках специфической и лучевой терапии, локализацией первичной опухоли и т. д. [16,17].…”

“…в своей работе продемонстрировали результаты мультицентрового исследования, которое показало, что среди 26 334 выживших пациентов с диагностированным ЗНО в возрасте до 20 лет 1987 были госпитализированы как минимум один раз по поводу осложнений со стороны костно-мышечной патологии, включая остеонекроз, остеопороз, патологические переломы, остеохондропатии, остеоартроз. Госпитализация в лечебные учреждения чаще отмечалась у выживших пациентов, перенесших терапию по поводу острого лимфобластного лейкоза с относительным риском (ОР) 1,6 (1,4-1,7), лимфомы с ОР 1,2 (1,0-1,3), опухолей ЦНС с ОР 1,5 (1,4-1,7), опухолей симпатической нервной системы с ОР 1,7 (1,4-1,7), опухолей костей скелета с ОР 2,6 (2,2-3,1) [17].…”